Current Strategies and Future Directions to Achieve Deep Molecular Response and Treatment-Free Remission in Chronic Myeloid Leukemia

被引：20

作者：

Annunziata, Mario ^{[1
]}

Bonifacio, Massimiliano ^{[2
]}

Breccia, Massimo ^{[3
]}

Castagnetti, Fausto ^{[4
]}

Gozzini, Antonella ^{[5
]}

Iurlo, Alessandra ^{[6
]}

Pregno, Patrizia ^{[7
]}

Stagno, Fabio ^{[8
]}

Specchia, Giorgina ^{[9
]}

机构：

[1] AORN Cardarelli Napoli, Hematol Div, Naples, Italy

[2] Univ Verona, Dept Med, Sect Hematol, Verona, Italy

[3] Sapienza Univ, Dept Translat & Precis Med, Rome, Italy

[4] Univ Bologna, S Orsola Malpighi Univ Hosp, Inst Hematol L&A Seragnoli, Dept Expt Diagnost & Specialty Med, Bologna, Italy

[5] AUO Careggi, Dept Cellular Therapy & Transfus Med, Florence, Italy

[6] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Hematol Div, Milan, Italy

[7] AOU Citta Salute & Sci Torino, Hematol Div, Oncol & Hematol Dept, Turin, Italy

[8] AOU Policlin V Emanuele, Div Hematol & Bone Marrow Transplant, Catania, Italy

[9] Univ Bari Aldo Moro, Dept Emergency & Organ Transplantat, Hematol Sect, Bari, Italy

来源：

FRONTIERS IN ONCOLOGY | 2020年 / 10卷

关键词：

chronic myeloid leukemia; deep molecular response; optimal strategies; treatment-free remission; tyrosine kinase inhibitors; TYROSINE KINASE INHIBITORS; IMATINIB DISCONTINUATION; FRONTLINE NILOTINIB; CLINICAL-PRACTICE; PEGINTERFERON ALPHA-2A; INTERFERON-ALPHA; RANDOMIZED-TRIAL; CML PATIENTS; DASATINIB; BCR-ABL1;

D O I：

10.3389/fonc.2020.00883

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The treatment of chronic myeloid leukemia (CML) has been radically changed by the approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity. CML is now managed as a chronic disease requiring long-term treatment and close molecular monitoring. It has been shown 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 many CML patients. However, only nilotinib has approval in this setting and a number of controversial aspects remain regarding treatment choices and timings, predictive factors, patient communication, and optimal strategies to achieve successful TFR. This narrative review aims to provide a comprehensive overview on how to optimize the path to DMR and TFR in patients with CML, and discusses recent data and future directions.

引用

页数：12

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