Journal Article Epublish 16 citations
PubMed: 32899879 DOI: 10.3390/cancers12092521
Incidences of Deep Molecular Responses and Treatment-Free Remission in de Novo CP-CML Patients.
Cancers (Basel) 12(9)
Authors: Gabriel Etienne, Stéphanie Dulucq, Fréderic Bauduer, Didier Adiko, François Lifermann, Corinne Dagada, Caroline Lenoir, Anna Schmitt, Emilie Klein, Samia Madene, Marie-Pierre Fort, Fontanet Bijou, Marius Moldovan, Beatrice Turcq, Fanny Robbesyn, Françoise Durrieu, Laura Versmée, Sandrine Katsahian, Carole Faberes, Axelle Lascaux, François-Xavier Mahon
Affiliations
- Service d'Hématologie, Institut Bergonié, 33076 Bordeaux, France.
- Institut National de la Santé et de la Recherche Médicale, U1218 ACTION, Université de Bordeaux, 33000 Bordeaux, France.
- Groupe France Intergroupe des Leucémies Myéloïdes Chroniques, Hôpital Haut-Lévêque, 33600 Pessac, France.
- Laboratoire d'Hématologie, Hôpital Haut Lévêque Centre Hospitalier Universitaire de Bordeaux, 33600 Pessac, France.
- Service d'Hématologie, Centre Hospitalier Côte Basque, 64100 Bayonne, France.
- Collège des Sciences de la Santé, Université de Bordeaux, 33000 Bordeaux, France.
- Service d'Hématologie, Centre Hospitalier de Libourne, 33500 Libourne, France.
- Service de Médecine Interne, Centre Hospitalier de Dax-Côte d'Argent, 40107 Dax, France.
- Service d'Oncologie-Hématologie, Centre Hospitalier de Pau, 64000 Pau, France.
- Service d'Hémato-Oncologie Radiothérapie, Polyclinique Bordeaux Nord Aquitaine, 33000 Bordeaux, France.
- Service de Médecine Interne et Hématologie, Centre Hospitalier Intercommunal Mont-de-Marsan-Pays des Sources, 40024 Mont de Marsan, France.
- Service d'Hématologie-Oncologie, Centre Hospitalier de Périgueux, 24000 Périgueux, France.
- Centre National de la Recherche Scientifique, SNC 5010, 33000 Bordeaux, France.
- Massachusetts General Hospital, Boston, MA 02114, USA.
- Unité de Recherche Clinique et Centre Investigation Clinique-Epidémiologie, Hôpitaux Universitaires Paris-Ouest Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris 5 Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Equipe 22, 75006 Paris, France.
- Service des maladies du sang, Hôpital Haut Lévêque Centre Hospitalier Universitaire de Bordeaux, 33600 Pessac, France.
Abstract
Tyrosine Kinase Inhibitors (TKIs) discontinuation in patients who had achieved a deep molecular response (DMR) offer now the opportunity of prolonged treatment-free remission (TFR). Aims of this study were to evaluate the proportion of de novo chronic-phase chronic myeloid leukemia (CP-CML) patients who achieved a sustained DMR and to identify predictive factors of DMR and molecular recurrence-free survival (MRFS) after TKI discontinuation. Over a period of 10 years, 398 CP-CML patients treated with first-line TKIs were included. Median age at diagnosis was 61 years, 291 (73%) and 107 (27%) patients were treated with frontline imatinib (IMA) or second- or third-generation TKIs (2-3G TKI), respectively. With a median follow-up of seven years (range, 0.6 to 13.8 years), 182 (46%) patients achieved a sustained DMR at least 24 months. Gender, transcript type, and Sokal and ELTS risk scores were significantly associated with a higher probability of sustained DMR while TKI first-line (IMA vs. 2-3G TKI) was not. We estimate that 28% of CML-CP would have been an optimal candidate for TKI discontinuation according to recent recommendations. Finally, 95 (24%) patients have entered in a TFR program. MRFS rates at 12 and 48 months were 55.1% (95% CI, 44.3% to 65.9%) and 46.9% (95% CI, 34.9% to 58.9%), respectively. In multivariate analyses, first-line 2-3G TKIs compared to IMA and TKI duration were the most significant factors of MRFS. Our results suggest that frontline TKIs have a significant impact on TFR in patients who fulfill the selection criteria for TKI discontinuation.
MeSH
Incidence, Leukemia, Myelogenous, Chronic, Bcr-Abl Positive, Therapeutics, Leukemia, Myeloid, Chronic-Phase
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- Activated naïve γδ T cells accelerate deep molecular response to BCR-ABL inhibitors in patients with chronic myeloid leukemia. Blood Cancer J, 2022
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