Saglio Giuseppe, Gale Robert P
Department of Clinical and Biological Sciences of the University of Turin, Orbassano-Torino, Italy.
Imperial College London, London, UK.
Br J Haematol. 2020 Aug;190(3):318-327. doi: 10.1111/bjh.16506. Epub 2020 Feb 14.
In addition to the best possible overall survival, discontinuation of the tyrosine kinase-inhibitor (TKI) treatment [treatment free remission (TFR)] without observing a recurrence of the disease has become a major goal of the therapy of chronic myelogenous leukemia (CML). Many clinical studies have demonstrated that TFR is possible, although for the moment limited to a fraction of the CML patients able to achieve a stable deep molecular response (DMR). The factors associated to the possibility of remaining in TFR or of losing it, have been investigated by a number of controlled and observation clinical trials and although total TKI treatment duration, DMR duration and stability and, more recently, also the depth of the molecular response obtained at the time of discontinuation have been shown to be significant elements, most of the factors associated with a higher possibility of a successful discontinuation still remain elusive and are here reviewed.
除了尽可能实现总体生存最佳外，在不出现疾病复发的情况下停用酪氨酸激酶抑制剂（TKI）治疗[无治疗缓解（TFR）]已成为慢性髓性白血病（CML）治疗的主要目标。许多临床研究表明TFR是有可能的，尽管目前仅限于一小部分能够实现稳定深度分子反应（DMR）的CML患者。一些对照和观察性临床试验已经对与维持或失去TFR可能性相关的因素进行了研究，虽然总的TKI治疗持续时间、DMR持续时间和稳定性，以及最近在停药时获得的分子反应深度已被证明是重要因素，但与成功停药可能性较高相关的大多数因素仍然难以捉摸，在此进行综述。
