Open AccessTreatment-free remission in patients with chronic myeloid leukemia: literature review
Author(s) -
Anna Petrová,
Ekaterina Chelysheva,
Anna Turkina
Publication year - 2019
Publication title -
onkogematologiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.118
H-Index - 3
eISSN - 2413-4023
pISSN - 1818-8346
DOI - 10.17650/1818-8346-2019-14-3-12-22
Subject(s) - discontinuation , medicine , myeloid leukemia , tyrosine kinase , clinical trial , oncology , tyrosine kinase inhibitor , quality of life (healthcare) , disease , minimal residual disease , leukemia , cancer , receptor , nursing
Tyrosine kinase inhibitors have radically changed the course of chronic myeloid leukemia, significantly increasing survival and reducing the risk of disease progression. Nearly 50–70 % of patients achieve a consistently low or undetectable level of minimal residual disease – a deep molecular response. The long-term tyrosine kinase inhibitors treatment in about one-third of patients is accompanied by toxicity which impairs the quality of life. Therefore, the safe treatment discontinuation is relevant. The results of clinical trials have shown 40-60% possibility of maintaining treatment-free remission in patients with long-term deep molecular respons; however, all patients with molecular relapse regain molecular remission after the resumption of tyrosine kinase inhibitors therapy. Currently, clinical and biological factors associated with maintaining treatment-free remission are being studied. It is assumed that cessation of tyrosine kinase inhibitors therapy can improve the quality of life, but approximately 30 % of patients are reporting musculoskeletal pain – so called “withdrawal syndrome” – that begins or worsens after stopping tyrosine kinase inhibitors therapy. The mechanisms for the development of this phenomenon are currently unclear. Thus, many aspects concerning treatment-free remission require to be studied, which determines the importance of clinical trials in this area.