Sánchez-Sosa Santiago, Stuckey Ruth, Segura Díaz Adrián, González San Miguel José David, Morales Ruiz Ylenia, Lakhawani Sunil Lakhawani, Sánchez Jose María Raya, Moreno Vega Melania, Tapia Torres María, López-Coronado Pilar, Perdomo María de Las Nieves Saez, Fernández Marta, Stoica Cornelia, Bilbao Sieyro Cristina, Gómez Casares María Teresa
Hospital Universitario de Gran Canaria Doctor Negrin (HUGCDN), 35019 Las Palmas de Gran Canaria, Spain.
Department of Specific Didactics, Faculty of Education, Universidad de Las Palmas de Gran Canaria (ULPGC), 35004 Las Palmas de Gran Canaria, Spain.
Hematol Rep. 2025 Aug 4;17(4):39. doi: 10.3390/hematolrep17040039.
: The advent of tyrosine kinase inhibitors (TKIs) revolutionized the management of chronic myeloid leukemia (CML), achieving survival rates near those of the general population. Despite this success, prolonged therapy presents challenges, including physical, emotional, and financial burdens. Treatment-free remission (TFR), defined as sustained deep molecular response (DMR) after discontinuing TKIs, has emerged as a viable clinical goal. This study evaluates real-world data from the Canary Islands Registry of CML (RCLMC) to explore outcomes, predictors, and the feasibility of TFR. : This retrospective observational study included 393 patients diagnosed with CML-CP between 2007 and 2023. Molecular response was monitored according to international guidelines. Survival probabilities were estimated using the Kaplan-Meier method. Logistic regression analysis was performed to identify predictors of molecular relapses after TKI discontinuation. : Of the 383 patients who received TKI treatment, 58.3% achieved molecular response grade 2 (MR2) (BCR-ABL1 ≤ 1%), 95.05% achieved MR2, and 50.5% reached MR4 within the first year. Of the 107 patients attempting TFR, 73.2% maintained remission at 36 months. Relapses occurred in 24 patients, all regaining molecular response upon reintroduction of TKIs. No cases of disease progression were observed. : Our findings support the feasibility and safety of TFR in a real-world clinical setting for well-selected patients, with outcomes consistent with international studies. The study underscores the importance of molecular monitoring and patient-specific strategies to optimize outcomes.
酪氨酸激酶抑制剂（TKIs）的出现彻底改变了慢性粒细胞白血病（CML）的治疗方式，使生存率接近普通人群。尽管取得了这一成功，但长期治疗带来了诸多挑战，包括身体、情感和经济负担。无治疗缓解（TFR），定义为停用TKIs后持续的深度分子反应（DMR），已成为一个可行的临床目标。本研究评估了加那利群岛CML注册研究（RCLMC）的真实世界数据，以探讨TFR的结果、预测因素和可行性。：这项回顾性观察性研究纳入了2007年至2023年间诊断为CML-CP的393例患者。根据国际指南监测分子反应。使用Kaplan-Meier方法估计生存概率。进行逻辑回归分析以确定停用TKI后分子复发的预测因素。：在接受TKI治疗的383例患者中，58.3%达到分子反应2级（MR2）（BCR-ABL1≤1%），95.05%在第一年内达到MR2，50.5%达到MR4。在尝试TFR的107例患者中，73.2%在36个月时维持缓解。24例患者出现复发，所有患者在重新使用TKIs后均恢复分子反应。未观察到疾病进展的病例。：我们的研究结果支持了在真实世界临床环境中对精心挑选的患者进行TFR的可行性和安全性，结果与国际研究一致。该研究强调了分子监测和针对患者的策略对优化结果的重要性。
