About: Imatinib and pegylated IFN-alfa2b discontinuation in first-line chronic myeloid leukemia patients following a major molecular response.     Goto   Sponge   NotDistinct   Permalink

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  • OBJECTIVES: Previous studies indicate that 40-50% of patients with chronic myeloid leukemia in prolonged complete molecular remission may discontinue imatinib therapy without imminent relapse. The combination of pegylated interferon-alpha (Peg-IFN-alfa2b) and imatinib may increase the rate of successful discontinuation. METHODS: In this pilot study, we prospectively stopped imatinib from patients (n = 12) who had achieved major molecular response (MMR) after ?12 months of treatment with either imatinib or imatinib+Peg-IFN-alfa2b. Molecular monitoring was carried out monthly for BCR-ABL1. In addition, analyses of lymphocyte immunophenotype, function, and plasma cytokines were performed. RESULTS: In the monotherapy group, 5/6 patients lost MMR within 4 months. One patient remains to date in MR(4.0) 61 months after discontinuation. In the combination therapy group, 2/6 patients relapsed within 4 months while still receiving Peg-IFN-alfa2b. Four of six patients were able to discontinue both treatments, but three of these patients relapsed after 3 months. One patient is still in sustained MR(4.0) at 58 months off all treatment. All relapsed patients re-responded to imatinib. The two successfully discontinued patients had either an increased number of NK-cells or functionally active T-cells. CONCLUSIONS: A higher frequency of relapsed patients in our study in comparison with other studies may be due to the shorter duration of imatinib treatment prior to discontinuation. However, in selected patients with an active immune system, even a short duration of TKI therapy ({2 yr) may allow for therapy discontinuation but this needs to be confirmed in larger prospective studies
  • OBJECTIVES: Previous studies indicate that 40-50% of patients with chronic myeloid leukemia in prolonged complete molecular remission may discontinue imatinib therapy without imminent relapse. The combination of pegylated interferon-alpha (Peg-IFN-alfa2b) and imatinib may increase the rate of successful discontinuation. METHODS: In this pilot study, we prospectively stopped imatinib from patients (n = 12) who had achieved major molecular response (MMR) after ?12 months of treatment with either imatinib or imatinib+Peg-IFN-alfa2b. Molecular monitoring was carried out monthly for BCR-ABL1. In addition, analyses of lymphocyte immunophenotype, function, and plasma cytokines were performed. RESULTS: In the monotherapy group, 5/6 patients lost MMR within 4 months. One patient remains to date in MR(4.0) 61 months after discontinuation. In the combination therapy group, 2/6 patients relapsed within 4 months while still receiving Peg-IFN-alfa2b. Four of six patients were able to discontinue both treatments, but three of these patients relapsed after 3 months. One patient is still in sustained MR(4.0) at 58 months off all treatment. All relapsed patients re-responded to imatinib. The two successfully discontinued patients had either an increased number of NK-cells or functionally active T-cells. CONCLUSIONS: A higher frequency of relapsed patients in our study in comparison with other studies may be due to the shorter duration of imatinib treatment prior to discontinuation. However, in selected patients with an active immune system, even a short duration of TKI therapy ({2 yr) may allow for therapy discontinuation but this needs to be confirmed in larger prospective studies (en)
Title
  • Imatinib and pegylated IFN-alfa2b discontinuation in first-line chronic myeloid leukemia patients following a major molecular response.
  • Imatinib and pegylated IFN-alfa2b discontinuation in first-line chronic myeloid leukemia patients following a major molecular response. (en)
skos:prefLabel
  • Imatinib and pegylated IFN-alfa2b discontinuation in first-line chronic myeloid leukemia patients following a major molecular response.
  • Imatinib and pegylated IFN-alfa2b discontinuation in first-line chronic myeloid leukemia patients following a major molecular response. (en)
skos:notation
  • RIV/61989592:15110/14:33150373!RIV15-MSM-15110___
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • S
http://linked.open...iv/cisloPeriodika
  • 5
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
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http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 20497
http://linked.open...ai/riv/idVysledku
  • RIV/61989592:15110/14:33150373
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • tyrosine kinase inhibitor; therapy discontinuation; interferon; immune system; chronic myeloid leukemia (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • US - Spojené státy americké
http://linked.open...ontrolniKodProRIV
  • [0B131A511485]
http://linked.open...i/riv/nazevZdroje
  • European Journal of Haematology
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 92
http://linked.open...iv/tvurceVysledku
  • Rohoň, Peter
  • Kreutzman, A.
  • Porkka, K.
  • Vakkila, J.
  • Hjorth-Hansen, H.
  • Koskenvesa, P.
  • Lundán, T.
  • Mustjoki, S.
  • Pihlman, M.
  • Remes, K.
  • Räsänen, A.
  • Simonsson, B.
  • Vakkila, E.
  • Vapaatalo, M.
issn
  • 0902-4441
number of pages
http://bibframe.org/vocab/doi
  • 10.1111/ejh.12258
http://localhost/t...ganizacniJednotka
  • 15110
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