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中文慢性髓性白血病患者停止酪氨酸激酶抑制剂治疗的监测和分析。

Monitoring and Analysis of Chinese Chronic Myeloid Leukemia Patients Who Have Stopped Tyrosine Kinase Inhibitor Therapy.

机构信息

Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

出版信息

Curr Med Sci. 2019 Apr;39(2):211-216. doi: 10.1007/s11596-019-2021-7. Epub 2019 Apr 23.

Abstract

Discontinuation of tyrosine kinase inhibitor (TKI) therapy after achieving a persistent deep molecular response (DMR) is an urgently needed treatment goal for chronic myeloid leukemia (CML) patients and has been included in the National Comprehensive Cancer Network (NCCN) guidelines (version 2.2017) for CML. Indeed, various studies have confirmed the feasibility of discontinuing TKI therapy. In this study, we analyzed data from 45 CML patients who had discontinued TKI therapy. Univariate analysis was performed to predict factors that were potentially related to treatment-free remission (TFR) and identify the differences between early relapse and late relapse. Out of the 45 patients, 20 exhibited molecular relapse after a median follow-up of 18 months (range, 1-54 months), and the estimated TFR at 24 months was 40%. The univariate analysis revealed that a high Sokal score and interruptions or dose reductions during TKI treatment were the only baseline factors associated with poor outcomes. Our results indicate that TKI discontinuation could be successfully put into practice in China.

摘要

酪氨酸激酶抑制剂 (TKI) 治疗达到持续深度分子反应 (DMR) 后停药是慢性髓性白血病 (CML) 患者急需的治疗目标,已被纳入国家综合癌症网络 (NCCN) 指南 (2017 年版) 用于 CML。事实上,多项研究已经证实了停止 TKI 治疗的可行性。在这项研究中,我们分析了 45 例停止 TKI 治疗的 CML 患者的数据。采用单因素分析预测与无治疗缓解 (TFR) 相关的潜在因素,并确定早期复发和晚期复发之间的差异。在这 45 例患者中,20 例在中位随访 18 个月(范围为 1-54 个月)后出现分子复发,24 个月时的 TFR 估计值为 40%。单因素分析显示,较高的 Sokal 评分和 TKI 治疗期间的中断或剂量减少是与不良结局相关的唯一基线因素。我们的结果表明,TKI 停药在中国可以成功实施。

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