Interruption or Discontinuation of Tyrosine Kinase Inhibitor Treatment in Chronic Myeloid Leukaemia: A Retrospective Cohort Study (SPARKLE) in Belgium

被引：5

作者：

Devos, Timothy ^{[1
]}

Verhoef, Gregor ^{[1
]}

Steel, Eva ^{[2
]}

Mazure, Dominiek ^{[2
]}

Lewalle, Philippe ^{[3
]}

Bron, Dominique ^{[3
]}

Berneman, Zwi ^{[4
]}

Benghiat, Fleur Samantha ^{[5
]}

Mineur, Philippe ^{[6
]}

Theunissen, Koen ^{[7
]}

Zachee, Pierre ^{[8
]}

Doyen, Chantal ^{[9
]}

Put, Natalie ^{[10
]}

Lejeune, Marie ^{[11
]}

Van Eygen, Koen ^{[12
]}

Havelange, Violaine ^{[13
]}

Reusens, Michael ^{[14
]}

Pluymers, Wim ^{[14
]}

Peeters, Karen ^{[14
]}

机构：

[1] Univ Hosp Leuven, Dept Hematol, Leuven, Belgium

[2] Univ Ziekenhuis Ghent, Ghent, Belgium

[3] Inst Jules Bordet, Brussels, Belgium

[4] Univ Ziekenhuis Antwerpen, Edegem, Belgium

[5] Hop Erasme, Brussels, Belgium

[6] Grand Hop Charleroi GHdC, Charleroi, Belgium

[7] Jessa Ziekenhuis, Campus Virga Jesse, Hasselt, Belgium

[8] Ziekenhuis Netwerk Antwerpen Stuivenberg, Antwerp, Belgium

[9] Ctr Hosp Univ UCL Namur, Yvoir, Belgium

[10] Ziekenhuis Oost Limburg, Campus Sint Jan, Genk, Belgium

[11] Ctr Hosp Univ Liege, Liege, Belgium

[12] AZ Groeninge, Campus Kennedylaan, Kortrijk, Belgium

[13] UCL St Luc, Woluwe St Lambert, Belgium

[14] Novartis Pharma NV SA, Vilvoorde, Belgium

来源：

ACTA HAEMATOLOGICA | 2019年 / 142卷 / 04期

关键词：

Chronic myeloid leukaemia; Tyrosine kinase inhibitor; Treatment interruption; discontinuation; Molecular response; Imatinib; Nilotinib; Dasatinib; Ponatinib; TREATMENT-FREE REMISSION; MOLECULAR RESPONSE; ADVERSE EVENTS; IMATINIB; RECOMMENDATIONS; MANAGEMENT; THERAPY; NILOTINIB; TRIAL;

D O I：

10.1159/000499329

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: To assess interruptions/discontinuations of tyrosine kinase inhibitor (TKI) treatment in Belgian patients with chronic myeloid leukaemia (CML). Methods: This retrospective study included patients with TKI interruptions/discontinuations of >= 4 continuous weeks (no clinical trial context) between May 2013 and May 2016. Data collection took place between October 2016 and February 2017. Results: All 60 participants (69 interruptions/discontinuations) had chronic-phase CML and 75% had at least a major molecular response (>= MMR) at interruption/discontinuation. Most interruptions/discontinuations occurred while on imatinib (36/69; 49%) and dasatinib (20/69; 29%). Most interruptions/discontinuations occurred due to side effects/intolerance (46/69; 67%); other reasons included a wish to conceive (6/69; 9%) and attempts to achieve treatment-free remission (TFR) (6/69; 9%). Interruptions due to side effects occurred later for imatinib- or dasatinib-treated patients than for those on nilotinib or ponatinib. Treatment was re-initiated in 62% (43/69) of cases. Most interruptions caused by side effects/intolerance were followed by treatment changes. All 4 patients with >= MR 4.5 at interruption/discontinuation and >= 11-month follow-up who had not restarted treatment maintained the response. Conclusion: Although TKIs are used for long-term CML treatment, physicians sometimes recommend interruptions/discontinuations. In this study, interruptions/discontinuations were mainly caused by side effects or intolerance, rather than TFR attempts.

引用

页码：197 / 207

页数：11