Results of following up patients with chronic myeloid leukemia and a deep molecular response without tyrosine kinase inhibitor therapy

A. G. Turkina, E. Yu Chelysheva, V. A. Shuvaev, G. A. Gusarova, A. V. Bykova, O. A. Shukhov, A. N. Petrova, M. V. Vakhrusheva, S. R. Goryacheva, L. Yu Kolosova, P. S. Krasikova, M. S. Fominykh, I. S. Martynkevich, A. O. Abdullaev, A. B. Sudarikov, V. G. Savchenko

Research output

2 Citations (Scopus)

Abstract

Aim. To assess the results of following up patients with chronic myeloid leukemia (CML) and a deep molecular response (MR) without tyrosine kinase inhibitor (TKI) therapy. Subjects and methods. The reasons for TKI discontinuation in 70 patients with CML and a deep MR of more than 1 year's duration were adverse events, pregnancy, and patients' decision. Information was collected retrospectively and prospectively in 2008- 2016. Results. The median follow-up after TKI therapy discontinuation was 23 months (2 to 100 months). At 6, 12 and 24 months after TKI therapy discontinuation, the cumulative incidence of major MR (MMR) loss was 28, 41 and 48%, respectively; the survival rates without TKI therapy were 69, 50, and 39%, respectively. MMR loss was noted in 28 (88%) patients at 12 months; it was not seen without TKI therapy at 2-year follow-up. Deaths due to CML progression were absent. The Sokal risk group was a reliable factor influencing MMR loss (p ≤ 0.05). The cumulative recovery rate for deep MR after resumption of TKI use was 73 and 100% at 12 and 24 months, respectively, with a median follow-up of 24 months (1 to 116 months). Deep MR recovered at a later time when the therapy was resumed more than 30 days after MMR loss. Conclusion. Safe follow-up is possible in about 50% of the patients with CML and stable deep MRs without TKI therapy. The introduction of this approach into clinical practice requires regular molecular genetic monitoring and organizational activities. Biological factors in maintaining remission after TKI discontinuation need to be separately studied.

Original languageRussian
Pages (from-to)86-96
Number of pages11
JournalTerapevticheskii Arkhiv
Volume89
Issue number12
DOIs
Publication statusPublished - 1 Jan 2017

Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Turkina, A. G. ; Chelysheva, E. Yu ; Shuvaev, V. A. ; Gusarova, G. A. ; Bykova, A. V. ; Shukhov, O. A. ; Petrova, A. N. ; Vakhrusheva, M. V. ; Goryacheva, S. R. ; Kolosova, L. Yu ; Krasikova, P. S. ; Fominykh, M. S. ; Martynkevich, I. S. ; Abdullaev, A. O. ; Sudarikov, A. B. ; Savchenko, V. G. / Results of following up patients with chronic myeloid leukemia and a deep molecular response without tyrosine kinase inhibitor therapy. In: Terapevticheskii Arkhiv. 2017 ; Vol. 89, No. 12. pp. 86-96.
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title = "Results of following up patients with chronic myeloid leukemia and a deep molecular response without tyrosine kinase inhibitor therapy",
abstract = "Aim. To assess the results of following up patients with chronic myeloid leukemia (CML) and a deep molecular response (MR) without tyrosine kinase inhibitor (TKI) therapy. Subjects and methods. The reasons for TKI discontinuation in 70 patients with CML and a deep MR of more than 1 year's duration were adverse events, pregnancy, and patients' decision. Information was collected retrospectively and prospectively in 2008- 2016. Results. The median follow-up after TKI therapy discontinuation was 23 months (2 to 100 months). At 6, 12 and 24 months after TKI therapy discontinuation, the cumulative incidence of major MR (MMR) loss was 28, 41 and 48{\%}, respectively; the survival rates without TKI therapy were 69, 50, and 39{\%}, respectively. MMR loss was noted in 28 (88{\%}) patients at 12 months; it was not seen without TKI therapy at 2-year follow-up. Deaths due to CML progression were absent. The Sokal risk group was a reliable factor influencing MMR loss (p ≤ 0.05). The cumulative recovery rate for deep MR after resumption of TKI use was 73 and 100{\%} at 12 and 24 months, respectively, with a median follow-up of 24 months (1 to 116 months). Deep MR recovered at a later time when the therapy was resumed more than 30 days after MMR loss. Conclusion. Safe follow-up is possible in about 50{\%} of the patients with CML and stable deep MRs without TKI therapy. The introduction of this approach into clinical practice requires regular molecular genetic monitoring and organizational activities. Biological factors in maintaining remission after TKI discontinuation need to be separately studied.",
keywords = "Chronic myeloid leukemia, Chronic myeloid leukemia imatinib, Dasatinib, Deep molecular response, Nilotinib, Remission without therapy",
author = "Turkina, {A. G.} and Chelysheva, {E. Yu} and Shuvaev, {V. A.} and Gusarova, {G. A.} and Bykova, {A. V.} and Shukhov, {O. A.} and Petrova, {A. N.} and Vakhrusheva, {M. V.} and Goryacheva, {S. R.} and Kolosova, {L. Yu} and Krasikova, {P. S.} and Fominykh, {M. S.} and Martynkevich, {I. S.} and Abdullaev, {A. O.} and Sudarikov, {A. B.} and Savchenko, {V. G.}",
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language = "русский",
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pages = "86--96",
journal = "ТЕРАПЕВТИЧЕСКИЙ АРХИВ (TERAPEVTICHESKII ARKHIV)",
issn = "0040-3660",
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number = "12",

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Turkina, AG, Chelysheva, EY, Shuvaev, VA, Gusarova, GA, Bykova, AV, Shukhov, OA, Petrova, AN, Vakhrusheva, MV, Goryacheva, SR, Kolosova, LY, Krasikova, PS, Fominykh, MS, Martynkevich, IS, Abdullaev, AO, Sudarikov, AB & Savchenko, VG 2017, 'Results of following up patients with chronic myeloid leukemia and a deep molecular response without tyrosine kinase inhibitor therapy', Terapevticheskii Arkhiv, vol. 89, no. 12, pp. 86-96. https://doi.org/10.17116/terarkh2017891286-96

Results of following up patients with chronic myeloid leukemia and a deep molecular response without tyrosine kinase inhibitor therapy. / Turkina, A. G.; Chelysheva, E. Yu; Shuvaev, V. A.; Gusarova, G. A.; Bykova, A. V.; Shukhov, O. A.; Petrova, A. N.; Vakhrusheva, M. V.; Goryacheva, S. R.; Kolosova, L. Yu; Krasikova, P. S.; Fominykh, M. S.; Martynkevich, I. S.; Abdullaev, A. O.; Sudarikov, A. B.; Savchenko, V. G.

In: Terapevticheskii Arkhiv, Vol. 89, No. 12, 01.01.2017, p. 86-96.

Research output

TY - JOUR

T1 - Results of following up patients with chronic myeloid leukemia and a deep molecular response without tyrosine kinase inhibitor therapy

AU - Turkina, A. G.

AU - Chelysheva, E. Yu

AU - Shuvaev, V. A.

AU - Gusarova, G. A.

AU - Bykova, A. V.

AU - Shukhov, O. A.

AU - Petrova, A. N.

AU - Vakhrusheva, M. V.

AU - Goryacheva, S. R.

AU - Kolosova, L. Yu

AU - Krasikova, P. S.

AU - Fominykh, M. S.

AU - Martynkevich, I. S.

AU - Abdullaev, A. O.

AU - Sudarikov, A. B.

AU - Savchenko, V. G.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Aim. To assess the results of following up patients with chronic myeloid leukemia (CML) and a deep molecular response (MR) without tyrosine kinase inhibitor (TKI) therapy. Subjects and methods. The reasons for TKI discontinuation in 70 patients with CML and a deep MR of more than 1 year's duration were adverse events, pregnancy, and patients' decision. Information was collected retrospectively and prospectively in 2008- 2016. Results. The median follow-up after TKI therapy discontinuation was 23 months (2 to 100 months). At 6, 12 and 24 months after TKI therapy discontinuation, the cumulative incidence of major MR (MMR) loss was 28, 41 and 48%, respectively; the survival rates without TKI therapy were 69, 50, and 39%, respectively. MMR loss was noted in 28 (88%) patients at 12 months; it was not seen without TKI therapy at 2-year follow-up. Deaths due to CML progression were absent. The Sokal risk group was a reliable factor influencing MMR loss (p ≤ 0.05). The cumulative recovery rate for deep MR after resumption of TKI use was 73 and 100% at 12 and 24 months, respectively, with a median follow-up of 24 months (1 to 116 months). Deep MR recovered at a later time when the therapy was resumed more than 30 days after MMR loss. Conclusion. Safe follow-up is possible in about 50% of the patients with CML and stable deep MRs without TKI therapy. The introduction of this approach into clinical practice requires regular molecular genetic monitoring and organizational activities. Biological factors in maintaining remission after TKI discontinuation need to be separately studied.

AB - Aim. To assess the results of following up patients with chronic myeloid leukemia (CML) and a deep molecular response (MR) without tyrosine kinase inhibitor (TKI) therapy. Subjects and methods. The reasons for TKI discontinuation in 70 patients with CML and a deep MR of more than 1 year's duration were adverse events, pregnancy, and patients' decision. Information was collected retrospectively and prospectively in 2008- 2016. Results. The median follow-up after TKI therapy discontinuation was 23 months (2 to 100 months). At 6, 12 and 24 months after TKI therapy discontinuation, the cumulative incidence of major MR (MMR) loss was 28, 41 and 48%, respectively; the survival rates without TKI therapy were 69, 50, and 39%, respectively. MMR loss was noted in 28 (88%) patients at 12 months; it was not seen without TKI therapy at 2-year follow-up. Deaths due to CML progression were absent. The Sokal risk group was a reliable factor influencing MMR loss (p ≤ 0.05). The cumulative recovery rate for deep MR after resumption of TKI use was 73 and 100% at 12 and 24 months, respectively, with a median follow-up of 24 months (1 to 116 months). Deep MR recovered at a later time when the therapy was resumed more than 30 days after MMR loss. Conclusion. Safe follow-up is possible in about 50% of the patients with CML and stable deep MRs without TKI therapy. The introduction of this approach into clinical practice requires regular molecular genetic monitoring and organizational activities. Biological factors in maintaining remission after TKI discontinuation need to be separately studied.

KW - Chronic myeloid leukemia

KW - Chronic myeloid leukemia imatinib

KW - Dasatinib

KW - Deep molecular response

KW - Nilotinib

KW - Remission without therapy

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U2 - 10.17116/terarkh2017891286-96

DO - 10.17116/terarkh2017891286-96

M3 - статья

C2 - 29411766

AN - SCOPUS:85042187426

VL - 89

SP - 86

EP - 96

JO - ТЕРАПЕВТИЧЕСКИЙ АРХИВ (TERAPEVTICHESKII ARKHIV)

JF - ТЕРАПЕВТИЧЕСКИЙ АРХИВ (TERAPEVTICHESKII ARKHIV)

SN - 0040-3660

IS - 12

ER -