[Chronic myeloid leukemia: state-of-the-art management]

Rinsho Ketsueki. 2018;59(6):747-754. doi: 10.11406/rinketsu.59.747.
[Article in Japanese]

Abstract

Treatment-free remission leading to a sustained deep molecular response (DMR) following the discontinuation of tyrosine kinase inhibitor (TKI) is a therapeutic goal in patients with chronic myeloid leukemia chronic phase (CML-CP). In 2017, discontinuing TKI treatment at the outside of clinical trials was recommended for the first time by National Comprehensive Cancer Network guidelines. The criteria for TKI discontinuation include at least 3 years of TKI therapy, a stable DMR for ≥2 years, and monthly molecular monitoring during the first 6 months following discontinuation of treatment. Moreover, discontinuing TKI treatment at the outset of clinical trials may soon be recommended by the Japanese CML guidelines. Thus, achieving a sustained DMR is the current focus of research in CML-CP patients without a history of TKI resistance.

Keywords: Deep molecular response; International scale; Treatment-free remission; Tyrosine kinase inhibitor.

Publication types

  • Review

MeSH terms

  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy*
  • Protein Kinase Inhibitors / therapeutic use*
  • Remission Induction
  • Treatment Outcome

Substances

  • Protein Kinase Inhibitors