在慢性髓性白血病的无治疗缓解之路上：“其他人”如何？
On the road to treatment-free remission in chronic myeloid leukemia: what about 'the others'?
机构信息
Hematology Section and BMT Unit, Rodolico Hospital, AOU Policlinico - V. Emanuele , Catania, Italy.
Hematology, Department of Precision and Translational Medicine, Policlinico Umberto 1, Sapienza University , Rome, Italy.
出版信息
Expert Rev Anticancer Ther. 2020 Dec;20(12):1075-1081. doi: 10.1080/14737140.2020.1829483. Epub 2020 Oct 8.
INTRODUCTION
The treatment of chronic myeloid leukemia (CML) has been drastically changed by the approval of tyrosine kinase inhibitors (TKIs). CML is now managed as a chronic disease requiring both long-term treatment and close molecular monitoring in the majority of patients.
AREAS COVERED
Evidence suggests that in a substantial number of patients who have achieved a stable deep molecular response (DMR), TKI treatment can be safely discontinued without loss of response. Therefore, treatment-free remission (TFR), through the achievement of a DMR, is increasingly regarded as a feasible treatment goal in about 20% to 40% CML patients. Nevertheless, a proportion of patients with chronic-phase CML treated with TKIs remain in stable MMR and do not achieve a DMR.
EXPERT OPINION
We provide prospective views on how it is possible to optimize treatment for patients in stable MMR but not in DMR in order to finalize the therapeutic strategy.
简介
酪氨酸激酶抑制剂（TKI）的批准极大地改变了慢性髓性白血病（CML）的治疗方法。在大多数患者中，CML 现在被作为一种需要长期治疗和密切分子监测的慢性疾病来管理。
涵盖领域
有证据表明，在相当数量达到稳定深层分子反应（DMR）的患者中，TKI 治疗可以安全停药而不会失去反应。因此，通过实现 DMR，无治疗缓解（TFR）越来越被认为是大约 20%至 40%的 CML 患者可行的治疗目标。然而，接受 TKI 治疗的慢性期 CML 患者中有一部分仍处于稳定的微小残留病灶（MRM），并未达到 DMR。
专家意见
我们对如何优化稳定 MMR 但未达到 DMR 的患者的治疗提出了前瞻性观点，以最终确定治疗策略。
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