Chronic myeloid leukaemia: going off piste

Abstract

Imatinib, and more potent tyrosine kinase inhibitors (TKIs), have transformed chronic-phase chronic myeloid leukaemia from a universally fatal disease to a chronic illness. For many patients, the main symptoms and risks associated with chronic myeloid leukaemia arise from the side-effects of treatment, rather than from the disease itself. Additionally, the lifetime cost of drug treatment for chronic myeloid leukaemia is a substantial burden on individuals and communities. These considerations have led patients and physicians to explore the possibility of TKI discontinuation after achievement of a sustained deep molecular response (so-called treatment-free remission). 1 Hughes TP Ross DM Moving treatment-free remission into mainstream clinical practice in CML. Blood. 2016; 128: 17-23 Crossref PubMed Scopus (242) Google Scholar Discontinuation of tyrosine kinase inhibitor therapy in chronic myeloid leukaemia (EURO-SKI): a prespecified interim analysis of a prospective, multicentre, non-randomised, trialPatients with chronic myeloid leukaemia who have achieved deep molecular responses have good molecular relapse-free survival. Such patients should be considered for TKI discontinuation, particularly those who have been in deep molecular response for a long time. Stopping treatment could spare patients from treatment-induced side-effects and reduce health expenditure. Full-Text PDF