Treatment Free Remission (TFR) in Chronic Myeloid Leukemia-Chronic Phase (CML-CP), Kuwait Experience

Abstract

Introduction: CML is one of the successful stories in oncology. Treatment of CML has evolved and goals of therapy have changed over the years. Treatment free remission (TFR) is becoming an attractive goal in CML patients (pts) especially in younger population. Aim: To evaluate the trend of TFR in CML treated pts in Kuwait. Method: Retrospective analysis of CML pts treated in Kuwait Cancer Control Center (KCCC) who had a trial of TFR. Data were collected from the charts and electronic medical records. Pts who stopped tyrosine kinase inhibitor (TKI) due to intolerance or pregnancy were included if they were in deep molecular remission (DMR) (³MR4.0) regardless of the duration of therapy. Results: A total of 42 pts was eligible for TFR. Most of our pts were treated with imatinib (93%). All patients achieved optimal milestones, however pts who stopped treatment in DMR due to intolerance or pregnancy were included. Most of our pts were young with a median age of 38 yrs and had a low risk Sokal/ELTS score. Our cohort of pts had a long duration of TKI exposure (103 mons) and DMR (70 mons). At a median follow up of 50 mons, TFR rate was 74%. As shown in table 2, 10 pts (24%) lost TFR and were able to regain DMR upon re-starting TKI. All of them were treated with imatinib. Conclusion: Successful TFR rates are high among pts treated in Kuwait. This is largely due to a longer duration of therapy and higher percentage of pts with low risk Sokal/ELTS score. Keywords CML, treatment free remission, TFR