Incidences of Deep Molecular Responses and Treatment-Free Remission in de Novo CP-CML Patients - Archive ouverte HAL
Article Dans Une Revue Cancers Année : 2020

Incidences of Deep Molecular Responses and Treatment-Free Remission in de Novo CP-CML Patients

Gabriel Etienne
Fréderic Bauduer
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François Lifermann
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Emilie Klein
Béatrice Turcq
Laura Versmée

Résumé

Background: Tyrosine Kinase Inhibitors (TKIs) discontinuation in patients who had achieved a deep molecular response (DMR) offer now the opportunity of prolonged treatment-free remission (TFR). Patients and Methods: Aims of this study were to evaluate the proportion of de novo chronic-phase chronic myeloid leukemia (CP-CML) patients who achieved a sustained DMR and to identify predictive factors of DMR and molecular recurrence-free survival (MRFS) after TKI discontinuation. Results: Over a period of 10 years, 398 CP-CML patients treated with first-line TKIs were included. Median age at diagnosis was 61 years, 291 (73%) and 107 (27%) patients were treated with frontline imatinib (IMA) or second- or third-generation TKIs (2-3G TKI), respectively. With a median follow-up of seven years (range, 0.6 to 13.8 years), 182 (46%) patients achieved a sustained DMR at least 24 months. Gender, BCR-ABL1 transcript type, and Sokal and ELTS risk scores were significantly associated with a higher probability of sustained DMR while TKI first-line (IMA vs. 2-3G TKI) was not. We estimate that 28% of CML-CP would have been an optimal candidate for TKI discontinuation according to recent recommendations. Finally, 95 (24%) patients have entered in a TFR program. MRFS rates at 12 and 48 months were 55.1% (95% CI, 44.3% to 65.9%) and 46.9% (95% CI, 34.9% to 58.9%), respectively. In multivariate analyses, first-line 2-3G TKIs compared to IMA and TKI duration were the most significant factors of MRFS. Conclusions: Our results suggest that frontline TKIs have a significant impact on TFR in patients who fulfill the selection criteria for TKI discontinuation.
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Dates et versions

hal-03085198 , version 1 (21-12-2020)

Identifiants

Citer

Gabriel Etienne, Stéphanie Dulucq, Fréderic Bauduer, Didier Adiko, François Lifermann, et al.. Incidences of Deep Molecular Responses and Treatment-Free Remission in de Novo CP-CML Patients. Cancers, 2020, 12 (9), pp.2521. ⟨10.3390/cancers12092521⟩. ⟨hal-03085198⟩

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