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Chronic Myeloid Leukemia
Observational study of chronic myeloid leukemia Italian patients who discontinued tyrosine kinase inhibitors in clinical practice
Ferrata Storti Foundation
Haematologica 2019 Volume 104(8):1589-1596
Carmen Fava,1 Giovanna Rege-Cambrin,1 Irene Dogliotti,1 Marco Cerrano,2 Paola Berchialla,1 Matteo Dragani,1 Gianantonio Rosti,3 Fausto Castagnetti,3 Gabriele Gugliotta,3 Bruno Martino,4 Carlo Gambacorti-Passerini,5
Elisabetta Abruzzese,6 Chiara Elena,7 Patrizia Pregno,8 Antonella Gozzini,9 Isabella Capodanno,10 Micaela Bergamaschi,11 Monica Crugnola,12 Monica Bocchia,13 Sara Galimberti,14 Davide Rapezzi,15 Alessandra Iurlo,16 Daniele Cattaneo,16 Roberto Latagliata,17 Massimo Breccia,17 Michele Cedrone,18 Marco Santoro,19 Mario Annunziata,20 Luciano Levato,21 Fabio Stagno,22 Francesco Cavazzini,23 Nicola Sgherza,24 Valentina Giai,25 Luigia Luciano,26 Sabina Russo,27 Pellegrino Musto,28 Giovanni Caocci,29 Federica Sorà,30 Francesco Iuliano,31 Francesca Lunghi,32 Giorgina Specchia,33 Fabrizio Pane,26 Dario Ferrero,2 Michele Baccarani3 and Giuseppe Saglio1
1Department of Clinical and Biological Sciences, University of Turin, Orbassano; 2Hematology Division, Department of Molecular Biotechnologies and Health Sciences, University of Turin, Turin; 3Institute of Hematology "L. & A. Seràgnoli", St. Orsola University Hospital, Bologna; 4Azienda Ospedaliera "Bianchi Melacrino Morelli", Reggio Calabria; 5University Milano Bicocca, San Gerardo Hospital, Monza; 6Haematology Unit, S. Eugenio Hospital, Rome; 7Hematology Hunit, Fondazione IRCCS Policlinico San Matteo, Pavia;
8A.O. Città della Salute e della Scienza di Torino, Turin; 9SC Terapie Cellulari e Medicina Trasfusionale, AOU Careggi, Florence; 10Hematology, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia; 11Division of Hematology 1, IRCCS AOU San Martino-IST, Genoa; 12Division of Hematology, University Hospital of Parma, Parma; 13Azienda Ospedaliera Universitaria, University of Siena, Siena; 14Hematology Department, University of Pisa, Pisa; 15S.C. Ematologia, ASO S. Croce e Carle, Cuneo; 16Haematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan; 17Department of Cellular Biotechnologies and Hematology, University La Sapienza, Rome; 18UOC of Hematology, San Giovanni - Addolorata Hospital, Rome; 19Hematology Unit, University of Palermo, Palermo; 20Division of Hematology, Ospedale Cardarelli, Naples; 21Department Hematology-Oncology, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro; 22Chair and Hematology Section, Ferrarotto Hospital, Catania; 23Department of Medical Sciences - Haematology and Physiopathology of Haemostasis Section, Ferrara; 24Division of Hematology, IRCCS Ospedale Casa Sollievo Sofferenza, San Giovanni Rotondo; 25Division of Haematology, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria; 26Division of Hematology - Departments of Clinical Medicine and Surgery, University of Naples Federico II, Naples; 27Department of Internal Medicine, AOU Policlinico di Messina, Messina; 28IRCCS, Centro Di Riferimento Oncologico Della Basilicata, Rionero in Vulture; 29Department of Medical Sciences, University of Cagliari, Cagliari; 30Hematology Department, University Cattolica del Sacro Cuore - Policlinico A. Gemelli, Rome; 31Presidio Ospedaliero N. Giannetasio - Azienda ASL 3, Rossano; 32Division of Haematology and Bone Marrow Transplant, Ospedale San Raffaele IRCCS, Milan and 33Division of Haematology with Transplant – Outpatients, Azienda Ospedaliero-Universitaria Policlinico Consorziale di Bari, Bari, Italy
ABSTRACT
It is judged safe to discontinue treatment with tyrosine kinase inhibitors (TKI) for chronic myeloid leukemia (CML) in experimental trials on treatment-free remission (TFR). We collected a total of 293 Italian patients with chronic phase CML who discontinued TKI in deep molecular response. Seventy-two percent of patients were on treatment with ima- tinib, and 28% with second generation TKI at the time of discontinuation. Median duration of treatment with the last TKI was 77 months [Interquartile Range (IQR) 54;111], median duration of deep molecular response was 46 months (IQR 31;74). Duration of treatment with TKI and duration of deep molecular response were shorter with second generation TKI than with imatinib (P<0.001). Eighty-eight percent of patients discon- tinued as per clinical practice, and reasons for stopping treatment were: tox- icity (20%), pregnancy (6%), and shared decision between treating physi- cian and patient (62%). After a median follow up of 34 months (range, 12-
Correspondence:
CARMEN FAVA
carmen.fava@unito.it
Received: October 8, 2018. Accepted: February 27, 2019. Pre-published: February 28, 2019.
doi:10.3324/haematol.2018.205054
Check the online version for the most updated information on this article, online supplements, and information on authorship & disclosures: www.haematologica.org/content/104/8/1589
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haematologica | 2019; 104(8)
1589
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