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Successful tyrosine kinase inhibitor discontinuation outside clinical trials - data from the population-based Swedish chronic myeloid leukaemia registry

Authors :
Flygt, Hjalmar
Sandin, Fredrik
Dahlén, Torsten
Dremaine, Arta
Lübking, Anna
Markevärn, Berit
Myhr-Eriksson, Kristina
Olsson, Karin
Olsson-Strömberg, Ulla
Själander, Anders
Söderlund, Stina
Wennström, Lovisa
Wadenvik, Hans
Stenke, Leif
Höglund, Martin
Richter, Johan
Flygt, Hjalmar
Sandin, Fredrik
Dahlén, Torsten
Dremaine, Arta
Lübking, Anna
Markevärn, Berit
Myhr-Eriksson, Kristina
Olsson, Karin
Olsson-Strömberg, Ulla
Själander, Anders
Söderlund, Stina
Wennström, Lovisa
Wadenvik, Hans
Stenke, Leif
Höglund, Martin
Richter, Johan
Publication Year :
2021

Abstract

Clinical trials show that tyrosine kinase inhibitor (TKI) treatment can be discontinued in selected patients with chronic myeloid leukaemia (CML). Although updated CML guidelines support such procedure in clinical routine, data on TKI stopping outside clinical trials are limited. In this retrospective study utilising the Swedish CML registry, we examined TKI discontinuation in a population-based setting. Out of 584 patients diagnosed with chronic-phase CML (CML-CP) in 2007-2012, 548 had evaluable information on TKI discontinuation. With a median follow-up of nine years from diagnosis, 128 (23%) discontinued TKI therapy (>= 1 month) due to achieving a DMR (deep molecular response) and 107 (20%) due to other causes (adverse events, allogeneic stem cell transplant, pregnancy, etc). Among those stopping in DMR, 49% re-initiated TKI treatment (median time to restart 4 center dot 8 months). In all, 38 patients stopped TKI within a clinical study and 90 outside a study. After 24 months 41 center dot 1% of patients discontinuing outside a study had re-initiated TKI treatment. TKI treatment duration pre-stop was longer and proportion treated with second-generation TKI slightly higher outside studies, conceivably affecting the clinical outcome. In summary we show that TKI discontinuation in CML in clinical practice is common and feasible and may be just as successful as when performed within a clinical trial.

Details

Database :
OAIster
Notes :
application/pdf, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1280664157
Document Type :
Electronic Resource
Full Text :
https://doi.org/10.1111.bjh.17392