1. Managing chronic myeloid leukemia for treatment-free remission: a proposal from the GIMEMA CML WP
- Author
-
Baccarani, Michele, Abruzzese, Elisabetta, Accurso, Vincenzo, Albano, Francesco, Annunziata, Mario, Barulli, Sara, Beltrami, Germana, Bergamaschi, Micaela, Binotto, Gianni, Bocchia, Monica, Caocci, Giovanni, Capodanno, Isabella, Cavazzini, Francesco, Cedrone, Michele, Cerrano, Marco, Crugnola, Monica, D’Adda, Mariella, Elena, Chiara, Fava, Carmen, Fazi, Paola, Fozza, Claudio, Galimberti, Sara, Giai, Valentina, Gozzini, Antonella, Gugliotta, Gabriele, Iurlo, Alessandra, La Barba, Gaetano, Levato, Luciano, Lucchesi, Alessandro, Luciano, Luigia, Lunghi, Francesca, Lunghi, Monia, Malagola, Michele, Marasca, Roberto, Martino, Bruno, Melpignano, Angela, Miggiano, Maria Cristina, Montefusco, Enrico, Musolino, Caterina, Palmieri, Fausto, Pregno, Patrizia, Rapezzi, Davide, Rege-Cambrin, Giovanna, Rupoli, Serena, Salvucci, Marzia, Sancetta, Rosaria, Sica, Simona, Spadano, Raffaele, Stagno, Fabio, Tiribelli, Mario, Tomassetti, Simona, Trabacchi, Elena, Bonifacio, Massimiliano, Breccia, Massimo, Castagnetti, Fausto, Pane, Fabrizio, Russo, Domenico, Saglio, Giuseppe, Soverini, Simona, Vigneri, Paolo, and Rosti, Gianantonio
- Abstract
Several papers authored by international experts have proposed recommendations on the management of BCR-ABL1+ chronic myeloid leukemia (CML). Following these recommendations, survival of CML patients has become very close to normal. The next, ambitious, step is to bring as many patients as possible into a condition of treatment-free remission (TFR). The Gruppo Italiano Malattie EMatologiche dell’Adulto (GIMEMA; Italian Group for Hematologic Diseases of the Adult) CML Working Party (WP) has developed a project aimed at selecting the treatment policies that may increase the probability of TFR, taking into account 4 variables: the need for TFR, the tyrosine kinase inhibitors (TKIs), the characteristics of leukemia, and the patient. A Delphi-like method was used to reach a consensus among the representatives of 50 centers of the CML WP. A consensus was reached on the assessment of disease risk (EUTOS Long Term Survival [ELTS] score), on the definition of the most appropriate age boundaries for the choice of first-line treatment, on the choice of the TKI for first-line treatment, and on the definition of the responses that do not require a change of the TKI (BCR-ABL1 ≤10% at 3 months, ≤1% at 6 months, ≤0.1% at 12 months, ≤0.01% at 24 months), and of the responses that require a change of the TKI, when the goal is TFR (BCR-ABL1 >10% at 3 and 6 months, >1% at 12 months, and >0.1% at 24 months). These suggestions may help optimize the treatment strategy for TFR.
- Published
- 2019
- Full Text
- View/download PDF