A Higher Neutrophil Count Is Associated with Favorable Achievement of Treatment-Free Remission in Patients with Chronic Myeloid Leukemia Who Received Second Generation Tyrosine Kinase Inhibitor as Frontline Treatment

被引:0
作者
Ureshino, Hiroshi [1 ,2 ,3 ]
Takeda, Yusuke [4 ]
Kamachi, Kazuharu [3 ]
Ono, Takaaki [5 ]
Iriyama, Noriyoshi [6 ]
Ohtsuka, Eiichi [7 ]
Sakaida, Emiko [4 ]
Kimura, Shinya [3 ]
机构
[1] Hiroshima Univ, Res Inst Radiat Biol & Med, Dept Hematol & Oncol, 1-2-3 Kasumi,Minami Ku, Hiroshima 7348553, Japan
[2] Hiroshima Univ, Res Inst Radiat Biol & Med RIRBM, Next Generat Dev Genome & Cellular Therapy Program, Hiroshima 7348553, Japan
[3] Saga Univ, Fac Med, Dept Internal Med, Div Hematol Resp Med & Oncol, Saga 8498501, Japan
[4] Chiba Univ Hosp, Dept Hematol, Chiba 2608677, Japan
[5] Hamamatsu Univ Sch Med, Div Hematol, Shizuoka 4313192, Japan
[6] Nihon Univ, Dept Med, Div Hematol & Rheumatol, Sch Med, Tokyo 1738610, Japan
[7] Oita Prefectural Hosp, Dept Hematol, Oita 8708511, Japan
基金
日本学术振兴会;
关键词
chronic myeloid leukemia; treatment-free remission; tyrosine kinase inhibitors; neutrophil; cancer immunology; MOLECULAR RESPONSE; IMATINIB DISCONTINUATION; DASATINIB; NILOTINIB; RELAPSE; LONGER;
D O I
10.3390/clinpract14040097
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: ABL1 tyrosine kinase inhibitor discontinuation securely became among the therapeutic goal for chronic myeloid leukemia chronic phase patients (CML-CP). To establish successful prognostic factors for treatment-free remission (TFR), it is necessary to diagnose the patients with high-risk molecular relapse, however, a biomarker for the achievement of TFR has not been completely elucidated. Recent investigations have determined that neutrophils function crucially in cancer immunology. Patients and Methods: The research was a multicenter retrospective observational study to examine the correlation between TFR and neutrophil counts before TKI discontinuation. The investigation included patients having Philadelphia chromosome-positive CML-CP who attempted the discontinuation of TKIs after a durable deep molecular response between January 2012 and July 2021 at four institutions in Japan. Results: 118 CML-CP patients in total discontinued TKIs and an estimated 36-month TFR rate was 65.1%. 52 patients received second-generation TKIs as frontline. Higher neutrophil count (>3210/mu L) at TKIs discontinuation was determined as an independent prognostic variable for TFR in patients who received second-generation TKIs as frontline [(HR, 0.235 (95%, confidence interval (CI) 0.078-0.711); p = 0.010]. Conclusions: The neutrophil-mediated immunomodulation can be a significant component for the effective achievement of TFR in CML supported by our clinical observation.
引用
收藏
页码:1216 / 1224
页数:9
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