Rea Delphine
Département Médico-Universitaire d'Hématologie, Paris, France; and France Intergroupe des Leucémies Myéloïdes Chroniques, Lyon, France.
Blood Adv. 2020 Nov 10;4(21):5589-5594. doi: 10.1182/bloodadvances.2020002538.
The paradigm for managing patients with chronic myeloid leukemia is evolving. In the recent past, restoring a normal life expectancy while patients are receiving never-ending targeted therapy with BCR-ABL1 tyrosine kinase inhibitors through prevention of progression to blast phase and mitigation of iatrogenic risks was considered the best achievable outcome. Now, long-term treatment-free remission with continued response off tyrosine kinase inhibitor therapy is recognized as the most optimal benefit of treatment. Indeed, numerous independent clinical trials provided solid proof that tyrosine kinase inhibitor discontinuation was feasible in patients with deep and sustained molecular responses. This article discusses when tyrosine kinase inhibitors may be safely stopped in clinical practice on the basis of the best and latest available evidence.
慢性髓性白血病患者的管理模式正在不断演变。在过去，通过预防疾病进展至急变期和减轻医源性风险，让患者在接受BCR-ABL1酪氨酸激酶抑制剂的无休止靶向治疗时恢复正常预期寿命，被认为是所能取得的最佳结果。如今，酪氨酸激酶抑制剂停药后仍持续缓解的长期无治疗缓解被视为治疗的最理想益处。事实上，众多独立临床试验提供了确凿证据，表明在获得深度且持续分子反应的患者中停用酪氨酸激酶抑制剂是可行的。本文基于现有最佳和最新证据，探讨在临床实践中何时可以安全地停用酪氨酸激酶抑制剂。
