Long-Term Outcomes after Imatinib Mesylate Discontinuation in Chronic Myeloid Leukemia Patients with Undetectable Minimal Residual Disease
Long-Term Outcomes after Imatinib Mesylate Discontinuation in Chronic Myeloid Leukemia Patients with Undetectable Minimal Residual Disease
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DOI：
10.1159/000440936
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发表时间：
2016-01-01
影响因子：
2.4
通讯作者：
Kwak, Jae-Yong
中科院分区：
文献类型：
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作者：
Yhim, Ho-Young;Lee, Na-Ri;Kwak, Jae-Yong
背景：甲氨酸伊马替尼（Imatinib mesylate， IM）停药在慢性髓系白血病-慢行期（CML-CP）伴有无法检测到的微小残留疾病（UMRD）的患者中正在积极研究中。然而，关于接受一线IM治疗的患者停药后的长期结果的数据有限。方法：在2009年6月至2013年1月期间，我们连续招募了CML-CP患者，这些患者在达到UMRD后停止IM治疗bb0 = 12个月。结果：共纳入19例患者，其中男8例，女11例。停药后，14名患者（74%）在中位4.0个月后UMRD消失。在14例分子复发患者中，12例（86%）在停药后的前9个月内复发，2例（14%）分别在20.5个月和22.8个月复发。停药2年后未见分子复发。中位随访58.1个月（范围23.0-66.5），估计5年的UMRD持续率为23.7%。所有分子复发的患者重新给予IM， 12名患者（86%）在中位5.3个月时达到UMRD。高风险Sokal评分、延迟UMRD实现和短期IM治疗与分子复发显著相关。结论：这些研究结果表明，在一线IM治疗后达到UMRD的患者停用IM在安全性和可行性方面具有良好的长期预后。(C) 2015 S. Karger AG，巴塞尔
Background: Imatinib mesylate (IM) discontinuation is under active investigation in chronic myeloid leukemia-chronic phase (CML-CP) patients with undetectable minimal residual disease (UMRD). However, limited data exist on the long-term outcomes following IM discontinuation in patients treated with frontline IM therapy. Methods: We consecutively enrolled patients with CML-CP who discontinued IM after achieving UMRD for >= 12 months between June 2009 and January 2013. Results: Nineteen patients (8 male, 11 female) were included. After IM discontinuation, 14 patients (74%) lost UMRD after a median of 4.0 months. Of the 14 patients with molecular relapses, 12 (86%) relapsed within the first 9 months after IM discontinuation and 2 (14%) relapsed at 20.5 and 22.8 months, respectively. No molecular relapse was observed after 2 years of IM discontinuation. With a median follow-up of 58.1 months (range 23.0-66.5), the estimated UMRD persistence rate at 5 years was 23.7%. IM was readministered in all patients with molecular relapse, and 12 patients (86%) reachieved UMRD at a median of 5.3 months. A high-risk Sokal score, delayed UMRD achievement and short-term IM therapy were significantly associated with molecular relapse. Conclusion: These findings suggest that IM discontinuation in patients who achieved UMRD after frontline IM therapy resulted in favorable long-term outcomes in terms of safety and feasibility. (C) 2015 S. Karger AG, Basel