Brazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , |
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 |
Resumo: | 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. |
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2023-12-06T19:27:39Z2023-12-06T19:27:39Z2022443402409https://doi.org/10.1016/j.htct.2022.04.0022531-1379http://hdl.handle.net/1843/61801http://orcid.org/0000-0001-7396-2495http://orcid.org/0000-0001-6637-3588http://orcid.org/0000-0001-5393-8041http://orcid.org/0000-0002-1891-464Xhttp://orcid.org/0000-0002-4751-1428http://orcid.org/0000-0001-7298-8570http://orcid.org/0000-0001-7975-0805http://orcid.org/0000-0002-7145-2552http://orcid.org/0000-0002-2122-7277Introduction 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.engUniversidade Federal de Minas GeraisUFMGBrasilMEDICINA - FACULDADE DE MEDICINAHematology, Transfusion and Cell TherapyNeoplasiasGuia de Prática ClínicaTerapêuticaPractice guidelineLeukemia myelogenous chronicBCR-ABL positiveTherapeuticsBrazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practiceinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://www.sciencedirect.com/science/article/pii/S2531137922000505?via%3DihubCarla BoquimpaniFernanda Salles SeguroGustavo Henrique Romani MagalhãesIngrid Luise Soares PintoIsrael BenditJaisson André Pagnoncelli BortoliniKatia Borgia Barbosa PagnanoRenato CentroneVaneuza Funkeapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/61801/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALBrazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice.pdfBrazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice.pdfapplication/pdf369136https://repositorio.ufmg.br/bitstream/1843/61801/2/Brazilian%20chronic%20myeloid%20leukemia%20working%20group%20recommendations%20for%20discontinuation%20of%20tyrosine%20kinase%20inhibitors%20in%20chronic%20myeloid%20leukemia%20in%20clinical%20practice.pdfec3baac2de2cbe8ee3672c7c1c6dfc3dMD521843/618012023-12-06 16:27:40.185oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-12-06T19:27:40Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Brazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice |
title |
Brazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice |
spellingShingle |
Brazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice Carla Boquimpani Practice guideline Leukemia myelogenous chronic BCR-ABL positive Therapeutics Neoplasias Guia de Prática Clínica Terapêutica |
title_short |
Brazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice |
title_full |
Brazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice |
title_fullStr |
Brazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice |
title_full_unstemmed |
Brazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice |
title_sort |
Brazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice |
author |
Carla Boquimpani |
author_facet |
Carla Boquimpani 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 |
author_role |
author |
author2 |
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 |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Carla Boquimpani 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 |
dc.subject.por.fl_str_mv |
Practice guideline Leukemia myelogenous chronic BCR-ABL positive Therapeutics |
topic |
Practice guideline Leukemia myelogenous chronic BCR-ABL positive Therapeutics Neoplasias Guia de Prática Clínica Terapêutica |
dc.subject.other.pt_BR.fl_str_mv |
Neoplasias Guia de Prática Clínica Terapêutica |
description |
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. |
publishDate |
2022 |
dc.date.issued.fl_str_mv |
2022 |
dc.date.accessioned.fl_str_mv |
2023-12-06T19:27:39Z |
dc.date.available.fl_str_mv |
2023-12-06T19:27:39Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/61801 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://doi.org/10.1016/j.htct.2022.04.002 |
dc.identifier.issn.pt_BR.fl_str_mv |
2531-1379 |
dc.identifier.orcid.pt_BR.fl_str_mv |
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 |
url |
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 |
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2531-1379 |
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eng |
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eng |
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Hematology, Transfusion and Cell Therapy |
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Universidade Federal de Minas Gerais |
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Universidade Federal de Minas Gerais |
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