Managing chronic myeloid leukemia for treatment-free remission: a proposal from the GIMEMA CML WP.
Adolescent
Adult
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Disease Management
Female
Fusion Proteins, bcr-abl
/ genetics
Health Care Costs
Health Care Surveys
Humans
Italy
/ epidemiology
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
/ diagnosis
Male
Middle Aged
Pregnancy
Protein Kinase Inhibitors
/ administration & dosage
Remission Induction
Retreatment
Treatment Outcome
Young Adult
Journal
Blood advances
ISSN: 2473-9537
Titre abrégé: Blood Adv
Pays: United States
ID NLM: 101698425
Informations de publication
Date de publication:
23 12 2019
23 12 2019
Historique:
received:
20
08
2019
accepted:
04
11
2019
entrez:
24
12
2019
pubmed:
24
12
2019
medline:
17
9
2020
Statut:
ppublish
Résumé
Several papers authored by international experts have proposed recommendations on the management of BCR-ABL1+ chronic myeloid leukemia (CML). Following these recommendations, survival of CML patients has become very close to normal. The next, ambitious, step is to bring as many patients as possible into a condition of treatment-free remission (TFR). The Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA; Italian Group for Hematologic Diseases of the Adult) CML Working Party (WP) has developed a project aimed at selecting the treatment policies that may increase the probability of TFR, taking into account 4 variables: the need for TFR, the tyrosine kinase inhibitors (TKIs), the characteristics of leukemia, and the patient. A Delphi-like method was used to reach a consensus among the representatives of 50 centers of the CML WP. A consensus was reached on the assessment of disease risk (EUTOS Long Term Survival [ELTS] score), on the definition of the most appropriate age boundaries for the choice of first-line treatment, on the choice of the TKI for first-line treatment, and on the definition of the responses that do not require a change of the TKI (BCR-ABL1 ≤10% at 3 months, ≤1% at 6 months, ≤0.1% at 12 months, ≤0.01% at 24 months), and of the responses that require a change of the TKI, when the goal is TFR (BCR-ABL1 >10% at 3 and 6 months, >1% at 12 months, and >0.1% at 24 months). These suggestions may help optimize the treatment strategy for TFR.
Identifiants
pubmed: 31869412
pii: 429987
doi: 10.1182/bloodadvances.2019000865
pmc: PMC6929396
doi:
Substances chimiques
BCR-ABL1 fusion protein, human
0
Protein Kinase Inhibitors
0
Fusion Proteins, bcr-abl
EC 2.7.10.2
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
4280-4290Informations de copyright
© 2019 by The American Society of Hematology.
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