Brazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice

• Autor(a) principal: Carla Boquimpani
• Data de Publicação: 2022
• Outros Autores: Fernanda Salles Seguro, Gustavo Henrique Romani Magalhães, Ingrid Luise Soares Pinto, Israel Bendit, Jaisson André Pagnoncelli Bortolini, Katia Borgia Barbosa Pagnano, Renato Centrone, Vaneuza Funke
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.1016/j.htct.2022.04.002; http://hdl.handle.net/1843/61801; http://orcid.org/0000-0001-7396-2495; http://orcid.org/0000-0001-6637-3588; http://orcid.org/0000-0001-5393-8041; http://orcid.org/0000-0002-1891-464X; http://orcid.org/0000-0002-4751-1428; http://orcid.org/0000-0001-7298-8570; http://orcid.org/0000-0001-7975-0805; http://orcid.org/0000-0002-7145-2552; http://orcid.org/0000-0002-2122-7277
• topic: Practice guideline; Leukemia myelogenous chronic; BCR-ABL positive; Therapeutics; Neoplasias; Guia de Prática Clínica; Terapêutica

Introduction Treatment-free remission (TFR) is a new goal of chronic myeloid leukemia (CML) therapy. TFR is feasible when the patient has achieved a deep and stable molecular response and met the criteria required to ensure its success. Treatment discontinuation should not be proposed to the CML patient if minimum conditions are not met. In Brazil, for example, molecular tests (BCR::ABL1) are not broadly available, making it difficult to monitor the patients adequately. Objective In this sense, providing TFR recommendations for Brazilian physicians are therefore necessary. These recommendations include the main criteria checklist to start the TKIs treatment discontinuing process in patients diagnosed with CML and the population-eligible characteristics for treatment discontinuation. Method Age, risk score at diagnosis, TKI treatment duration, BCR::ABL1 transcripts type, depth of the molecular response for treatment discontinuation, treatment adherence, patient monitoring and withdrawal syndrome are essential factors to consider in TFR. After TKI discontinuation, BCR::ABL1 transcripts monitoring should be more frequent. When a major molecular response loss is observed during the monitoring of a patient in TFR, the TKI treatment should be resumed.