Identification of chronic myeloid leukemia patients treated with imatinib who are potentially eligible for treatment discontinuation by assessing real-life molecular responses on the international scale in a EUTOS-certified lab. (April 2018)

• Record Type: Journal Article
• Authors: Heinrichs, Amélie; Dessars, Barbara; El Housni, Hakim; Pluymers, Wim; Peeters, Karen; Benghiat, Fleur S.; Heimann, Pierre
• Is Part Of: Leukemia research. Volume 67(2018)
• Page Start: 27
• Page End: 31
• Publication Date: 2018-04
• Subjects: CML chronic myeloid leukemia -- CML-CP chronic myeloid leukemia in chronic phase -- DMR deep molecular response -- ELN European LeukemiaNet -- ENESTFreedom Evaluating Nilotinib Efficacy and Safety in Clinical Trials – Following REsponsE in De nOvo CML-CP Patients -- ENESTop Evaluating Nilotinib Efficacy and Safety Trial -- EURO-SKI European Stop Tyrosine Kinase Inhibitor study -- EUTOS the European Treatment and Outcome Study -- IM imatinib -- IRIS International Randomized Study of Interferon and STI571 -- IS international scale -- y year -- m month -- MMR major molecular response -- MR molecular response -- RQ-PCR real-time quantitative reverse-transcription polymerase chain reaction -- SD standard deviation -- STIM Stop Imatinib study -- TFR treatment-free remission -- TKI tyrosine kinase inhibitor -- TWISTER Trial of Withdrawing Imatinib in Stable Remission -- ULB Université Libre de Bruxelles; Chronic myeloid leukemia -- Imatinib -- Real-life deep molecular response -- Treatment-free remission -- EUTOS -- Discontinuation; Leukemia -- Periodicals; Leukemia -- Periodicals; Leucémie -- Périodiques; Leukemia; Periodicals; Electronic journals; Electronic journals; 616.9941905
• DOI: 10.1016/j.leukres.2018.01.018
• Languages: English
• ISSNs: 0145-2126

Abstract

Highlights: Real-life molecular responses on international scale in EUTOS-certified laboratory. 53.4% of patients were in deep molecular responses ≥MR4.5 at last visit. 36.2% of patients had ≥MR4.5 and were treated for >5.8 years; 26.7% for >8 years. Potential patients for treatment-free remission attempt outside clinical trials were identified. Abstract: A retrospective study was performed to describe molecular responses (MR) on the international scale (IS) in patients with chronic myeloid leukemia (CML) treated with imatinib in routine clinical practice in Belgium and to identify patients potentially eligible for treatment discontinuation. The analysis included 116 patients with CML in chronic phase at treatment centers sending blood samples for molecular follow-up to a single EUTOS-certified laboratory. IS MR from the last patient visit between October 2014 and April 2015 were retrospectively collected. Most patients (93.1%) had an IS MR corresponding to an optimal response per European LeukemiaNet 2013 guidelines; 53.4% (62/116) of patients were in deep molecular responses ≥MR 4.5 at their last visit (mean treatment duration: 91.0 months) among whom 36.2% (42/116) had been receiving imatinib for >5.8 years and 26.7% (31/116) for >8 years (margins of error: 8.74% and 8.05%, respectively). These patients would likely have the highest chance of staying in treatment-free remission (TFR) upon discontinuation, based on published TFR trial data. Although our study only provides a snapshot in time of a patient's last MR reported, without precise information regarding MR duration, the study settings could nevertheless support the feasibility of attempting TFR outside clinical trials in the future.