Treatment-free remission after first-line dasatinib treatment in patients with chronic myeloid leukemia in the chronic phase: the D-NewS Study of the Kanto CML Study Group
Treatment-free remission after first-line dasatinib treatment in patients with chronic myeloid leukemia in the chronic phase: the D-NewS Study of the Kanto CML Study Group
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DOI：
10.1007/s12185-019-02801-z
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发表时间：
2020-01
影响因子：
2.1
通讯作者：
H. Yamaguchi;N. Takezako;K. Ohashi;K. Oba;T. Kumagai;Y. Kozai;H. Wakita;Koh Yamamoto;A. Fujita;T. Igarashi;C. Yoshida;K. Ohyashiki;S. Okamoto;J. Sakamoto;H. Sakamaki;K. Inokuchi
中科院分区：
文献类型：
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作者：
H. Yamaguchi;N. Takezako;K. Ohashi;K. Oba;T. Kumagai;Y. Kozai;H. Wakita;Koh Yamamoto;A. Fujita;T. Igarashi;C. Yoshida;K. Ohyashiki;S. Okamoto;J. Sakamoto;H. Sakamaki;K. Inokuchi
随着酪氨酸激酶抑制剂（TKI）的开发，慢性粒细胞白血病（CML）的治疗结果得到了显着改善。然而，由于CML的预后改善，TKI的长期给药出现了问题。本研究旨在验证是否有更多患者在停止使用达沙替尼作为一线治疗后可以实现无治疗缓解（TFR）。初治慢性期CML病例接受达沙替尼作为一线治疗。26例患者在24个月内达到深度分子学缓解（DMR），并能够将DMR再维持2年，因此停止了达沙替尼治疗。10例患者（38.5%）在12个月后达到DMR维持。16例患者证实复发，中位无复发生存期为5.1个月。重新开始治疗后6个月和12个月的累积DMR率分别为84.6%和100%。本研究的结果表明，12个月后DMR维持率为38.5%，与既往TKI停药试验无显著差异。达到DMR后的2年达沙替尼给药期并没有改善TFR率。这些结果表明，TKI的类型与更好的TFR率无关。
Treatment outcomes for chronic myeloid leukemia (CML) have dramatically improved with the development of tyrosine kinase inhibitors (TKI). However, due to the improved prognosis for CML, problems have arisen from long-term administration of TKI. The present study sought to verify whether more patients could achieve treatment-free remission (TFR) after stopping the administration of dasatinib using dasatinib as frontline treatment. Treatment-naïve chronic phase CML cases were treated with dasatinib as frontline treatment. Dasatinib treatment was stopped for 26 patients who achieved deep molecular response (DMR) within 24 months and were able to maintain DMR for an additional 2 years. Ten patients (38.5%) achieved DMR maintenance after 12 months. Recurrence was confirmed in 16 patients, and the median recurrence-free survival time was 5.1 months. The cumulative DMR rates at six and 12 months after restarting treatment were 84.6% and 100%, respectively. The results of this study demonstrated that the DMR maintenance rate after 12 months was 38.5%, which was not significantly different from previous TKI stop trials. The 2-year dasatinib administration period after reaching DMR did not contribute to improve TFR rates. These results suggest that the type of TKI is not associated with better TFR rates.