000076955 001__ 76955
000076955 005__ 20200117221619.0
000076955 0247_ $$2doi$$a10.1038/s41408-018-0125-0
000076955 0248_ $$2sideral$$a109783
000076955 037__ $$aART-2018-109783
000076955 041__ $$aeng
000076955 100__ $$aHernández-Boluda, J.C.
000076955 245__ $$aFeasibility of treatment discontinuation in chronic myeloid leukemia in clinical practice: results from a nationwide series of 236 patients
000076955 260__ $$c2018
000076955 5060_ $$aAccess copy available to the general public$$fUnrestricted
000076955 5203_ $$aOver half of chronic myeloid leukemia (CML) patients in deep molecular response do not lose the major molecular response (MMR) after stopping treatment with tyrosine kinase inhibitors (TKI). This strategy is safe in clinical trials, but its applicability in the real-life setting remains unsettled. We describe the outcomes after TKI discontinuation in a nationwide series of 236 CML patients. Median follow-up from treatment discontinuation was 21.5 months and 5 patients died from CML-unrelated causes. TKI therapy was reinitiated due to MMR loss (n = 52), increase = 1 log in BCR-ABL transcript level without losing MMR (n = 12), patient preference (n = 2), and withdrawal syndrome (n = 1). Treatment-free remission rate at 4 years was 64% (95% confidence interval, CI: 55%–72%). Cumulative incidence of molecular recurrence at 3 years was 33% (95% CI: 26%–38%). TKI treatment for < 5 years and MR4.5 duration shorter than 4 years were both associated with higher incidence of molecular recurrence. No patient had disease progression. Response status at last control was: MR4.5 (n = 196), MR4 (n = 15), MMR (n = 14), complete cytogenetic response (n = 10), and other (n = 1). A significant increase in Hb and cholesterol levels was observed after imatinib withdrawal. Our results demonstrate that TKI treatment discontinuation is feasible in real-life clinical practice.
000076955 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000076955 590__ $$a7.895$$b2018
000076955 591__ $$aONCOLOGY$$b23 / 229 = 0.1$$c2018$$dQ1$$eT1
000076955 591__ $$aHEMATOLOGY$$b6 / 73 = 0.082$$c2018$$dQ1$$eT1
000076955 592__ $$a2.82$$b2018
000076955 593__ $$aOncology$$c2018$$dQ1
000076955 593__ $$aHematology$$c2018$$dQ1
000076955 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000076955 700__ $$aPereira, A.
000076955 700__ $$aPastor-Galán, I.
000076955 700__ $$aAlvarez-Larrán, A.
000076955 700__ $$aSavchuk, A.
000076955 700__ $$aPuerta, J.M.
000076955 700__ $$aSánchez-Pina, J.M.
000076955 700__ $$aCollado, R.
000076955 700__ $$aDíaz-González, A.
000076955 700__ $$aAngona, A.
000076955 700__ $$aSagüés, M.
000076955 700__ $$aGarcía-Gutiérrez, V.
000076955 700__ $$aBoqué, C.
000076955 700__ $$aOsorio, S.
000076955 700__ $$aVallansot, R.
000076955 700__ $$0(orcid)0000-0001-8515-3599$$aPalomera, L.$$uUniversidad de Zaragoza
000076955 700__ $$aMendizábal, A.
000076955 700__ $$aCasado, L.F.
000076955 700__ $$aPérez-Encinas, M.
000076955 700__ $$aPérez-López, R.
000076955 700__ $$aFerrer-Marín, F.
000076955 700__ $$aSánchez-Guijo, F.
000076955 700__ $$aGarcía, C.
000076955 700__ $$aHeras, N.
000076955 700__ $$aLópez-Lorenzo, J.L.
000076955 700__ $$aCervantes, F.
000076955 700__ $$aSteegmann, J.L.
000076955 700__ $$aon, behalf, of, the, Grupo, Espanol, de, Leucemia, Mieloide, Cronica, (GELMC)
000076955 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000076955 773__ $$g8, 10 (2018), 91 [8 pp]$$pBLOOD CANCER JOURNAL$$tBLOOD CANCER JOURNAL$$x2044-5385
000076955 8564_ $$s225441$$uhttps://zaguan.unizar.es/record/76955/files/texto_completo.pdf$$yVersión publicada
000076955 8564_ $$s103353$$uhttps://zaguan.unizar.es/record/76955/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000076955 909CO $$ooai:zaguan.unizar.es:76955$$particulos$$pdriver
000076955 951__ $$a2020-01-17-21:52:32
000076955 980__ $$aARTICLE