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Managing chronic myeloid leukemia for treatment-free remission: A proposal from the GIMEMA CML WP
- Publication Year :
- 2019
-
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.
- Subjects :
- Male
Pediatrics
Fusion Proteins, bcr-abl
Chronic myelogenous leukemia
tyrosine kinase inhibitors
additional chromosomal-abnormalities
deep molecular responses
high-dose imatinib
randomized cml
domain mutations
prognostic-significance
cytogenetic response
frontline nilotinib
Pregnancy
chronic myeloid leukemia,management,recommendations,Gimema,treatment-free remission
hemic and lymphatic diseases
Antineoplastic Combined Chemotherapy Protocols
Medicine
Young adult
Disease management (health)
Myeloid Neoplasia
Remission Induction
Myeloid leukemia
Disease Management
Hematology
Health Care Costs
Middle Aged
Leukemia
Treatment Outcome
Italy
Retreatment
Treatment strategy
Female
management
Human
Adult
medicine.medical_specialty
Adolescent
Chronic Myeloid Leukemia
Protein Kinase Inhibitor
Socio-culturale
Treatment-Free Remission
Gimema
Myelogenous
Young Adult
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Long term survival
Humans
Protein Kinase Inhibitors
Antineoplastic Combined Chemotherapy Protocol
business.industry
medicine.disease
Health Care Cost
Settore MED/15 - MALATTIE DEL SANGUE
treatment in chronic phase chronic myeloid leukemia
Health Care Survey
Health Care Surveys
recommendations
Disease risk
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....099e2d47f735439108cad6efdedcee55