Zhao Xiao-Li, Hong Ming, Qiao Chun, Sun Qian, Zhu Han, Wang Shuai, Li Jian-Yong, Qian Si-Xuan, Zhu Yu
Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China.
Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Dec;29(6):1746-1751. doi: 10.19746/j.cnki.issn.1009-2137.2021.06.009.
To investigate the clinical characteristics of the patients with chronic myeloid leukemia (CML) discontinued tyrosine kinase inhibitors (TKI) therapy and the outcome of the patients.
35 cases of CML patients experienced initiative discontinuation of TKI therapy in our hospital from June 1st 2015 to December 31th 2019 were retrospectively analyzed. The TFR of the patients and the factors affecting it were analyzed.
The median duration of TKI administration was 72 (range 35-173) months in the 35 patients. Among these patients, 8 had experienced TKI dose reduction or suspension. All the enrolled patients have achieved at least MMR. The median time for these patients achieving MMR was 15 (range 3-75) months after administration of TKI, and for MMR maintenance before TKI suspension was 55 (range 13-164) months. After TKI withdrawal the median follow up time was 20.3 (range 3-57.9) months, 22 out of 35 patients kept TFR, among them, 2 （5.71%） patients restarted TKI after 12 month suspension, and maintained MMR during suspension. 13 （37.1%）patients lost MMR, among them, 9 patients restarted TKI treatment, and 5 of them achieved MR4.0 after the median duration of 3(2-5) month. No patients were found to have disease progression. The estimated TFR rate was 57.8% and 51.8% at 12 and 24 months after discontinuation, respectively. Other clinical characteristic related to relapse were also analyzed, including the cumulative TKI administration duration, cumulative MMR duration, time to achieve MMR, median age at diagnosis, risk stratification by Sokal score, TKI dose reduction and discontinuation history, and second-generation TKI administration before stopping TKI, however, no statistical difference was found.
TKI discontinuation is practical for CML patients in our center.
探讨慢性髓系白血病（CML）患者停用酪氨酸激酶抑制剂（TKI）治疗的临床特征及患者预后。
回顾性分析2015年6月1日至2019年12月31日在我院主动停用TKI治疗的35例CML患者。分析患者的无治疗缓解（TFR）情况及影响因素。
35例患者TKI给药中位持续时间为72（范围35 - 173）个月。其中8例曾经历TKI剂量减少或暂停。所有入组患者均至少达到主要分子学缓解（MMR）。这些患者达到MMR的中位时间为TKI给药后15（范围3 - 75）个月，TKI暂停前MMR维持时间为55（范围13 - 164）个月。TKI停药后中位随访时间为20.3（范围3 - 57.9）个月，35例患者中22例保持TFR，其中2例（5.71%）在停药12个月后重新开始TKI治疗，并在停药期间维持MMR。13例（37.1%）患者失去MMR，其中9例重新开始TKI治疗，5例在中位3（2 - 5）个月后达到MR4.0。未发现患者疾病进展。停药后12个月和24个月时估计的TFR率分别为57.8%和51.8%。还分析了其他与复发相关临床特征，包括TKI累计给药持续时间、累计MMR持续时间、达到MMR的时间、诊断时中位年龄、Sokal评分风险分层、TKI剂量减少和停药史以及停用TKI前第二代TKI给药情况，然而，未发现统计学差异。
在我们中心，TKI停药对CML患者是可行的。
