A Retrospective Analysis about Frequency of Monitoring in Italian Chronic Myeloid Leukemia Patients after Discontinuation

Successful discontinuation of tyrosine kinase inhibitors has been achieved in patients with chronic-phase chronic myeloid leukemia (CML). Careful molecular monitoring after discontinuation warrants safe and prompt resumption of therapy. We retrospectively evaluated how molecular monitoring has been...

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Main Authors: Matteo Dragani, Giovanna Rege Cambrin, Paola Berchialla, Irene Dogliotti, Gianantonio Rosti, Fausto Castagnetti, Isabella Capodanno, Bruno Martino, Marco Cerrano, Dario Ferrero, Carlo Gambacorti-Passerini, Monica Crugnola, Chiara Elena, Massimo Breccia, Alessandra Iurlo, Daniele Cattaneo, Sara Galimberti, Antonella Gozzini, Monica Bocchia, Francesca Lunghi, Michele Cedrone, Nicola Sgherza, Luigia Luciano, Sabina Russo, Marco Santoro, Valentina Giai, Giovanni Caocci, Luciano Levato, Elisabetta Abruzzese, Federica Sora, Giuseppe Saglio, Carmen Fava
Format: Article
Language:English
Published: MDPI AG 2020-11-01
Series:Journal of Clinical Medicine
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Online Access:https://www.mdpi.com/2077-0383/9/11/3692
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Summary:Successful discontinuation of tyrosine kinase inhibitors has been achieved in patients with chronic-phase chronic myeloid leukemia (CML). Careful molecular monitoring after discontinuation warrants safe and prompt resumption of therapy. We retrospectively evaluated how molecular monitoring has been conducted in Italy in a cohort of patients who discontinued tyrosine kinase inhibitor (TKI) treatment per clinical practice. The outcome of these patients has recently been reported—281 chronic-phase CML patients were included in this subanalysis. Median follow-up since discontinuation was 2 years. Overall, 2203 analyses were performed, 17.9% in the first three months and 38.4% in the first six months. Eighty-six patients lost major molecular response (MMR) in a mean time of 5.7 months—65 pts (75.6%) during the first six months. We evaluated the number of patients who would experience a delay in diagnosis of MMR loss if a three-month monitoring schedule was adopted. In the first 6 months, 19 pts (29.2%) would have a one-month delay, 26 (40%) a 2-month delay. Very few patients would experience a delay in the following months. A less intense frequency of monitoring, particularly after the first 6 months off treatment, would not have affected the success of treatment-free remission (TFR) nor put patients at risk of progression.
ISSN:2077-0383