Recommendations from a Portuguese Expert Group for Discontinuation of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia Patients in Clinical Practice

Authors

  • Antonio Almeida Department of Hematology. Hospital da Luz. Lisboa.
  • Francesca Pierdomenico Department of Hematology. Instituto Português de Oncologia. Lisboa.
  • Blanca Polo Guerrero Department of Hematology. Hospital de Santa Maria. Centro Hospitalar Universitário Lisboa Norte. Lisboa.
  • Filipa Saraiva Department of Hematology. Hospital de Santo António dos Capuchos. Centro Hospitalar Lisboa Central. Lisboa.
  • Ana Montalvão Department of Oncology. Hospital José Joaquim Fernandes. Unidade Local de Saúde do Baixo Alentejo. Beja.
  • Jorge Coutinho Department of Clinical Hematology. Centro Hospitalar e Universitário do Porto. Porto.
  • Mário Mariz Department of Onco-Hematology. Instituto Português de Oncologia. Porto.
  • Teresa Melo Department of Clinical Hematology. Centro Hospitalar de Vila Nova de Gaia/Espinho. Vila Nova de Gaia.
  • Maria João Santos Department of Clinical Hematology. Hospital Pedro Hispano. Unidade Local de Saúde de Matosinhos. Matosinhos.
  • Alexandra Pereira Department of Clinical Hematology. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Nuno Cerveira Department of Genetics and Research Centre. Portuguese Oncology Institute. Porto.

DOI:

https://doi.org/10.20344/amp.11823

Keywords:

Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Portugal, Protein Kinase Inhibitors, Remission Induction

Abstract

Until recently, the main goal of chronic myeloid leukemia therapy was disease control with the best overall survival, which required lifelong treatment. However, currently, the treatment-free remission concept is becoming an important goal in clinical practice, and several tyrosine kinase inhibitors discontinuation studies have shown that  round 50% of patients with a durable deep molecular response beyond major molecular response successfully interrupt tyrosine kinase inhibitors for at least three years without loss of molecular response. However, and regardless of the existing evidence, the exact conditions for attempting treatment-free remission remain poorly defined. Different authors tried to guide the clinical decision regarding this topic but there are some points that differ, namely with respect to the recommended duration of tyrosine kinase inhibitors therapy and the appropriate molecular response prior to treatment-free remission. The goal of this article is to propose an algorithm to guide clinical practice in Portugal concerning chronic phase-chronic myeloid leukemia patients who wish to attempt treatment-free remission, since there are no national guidelines.

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Author Biography

Antonio Almeida, Department of Hematology. Hospital da Luz. Lisboa.

Dt.Nascimento  : 23/10/1970 Dt.Inscrição . :  7/06/1995 Format. : INGLATERRA Faculdade. . . : CAMBRIDGE

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Published

2019-08-01

How to Cite

1.
Almeida A, Pierdomenico F, Guerrero BP, Saraiva F, Montalvão A, Coutinho J, Mariz M, Melo T, Santos MJ, Pereira A, Cerveira N. Recommendations from a Portuguese Expert Group for Discontinuation of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia Patients in Clinical Practice. Acta Med Port [Internet]. 2019 Aug. 1 [cited 2023 Jan. 31];32(7-8):550-7. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/11823

Issue

Section

Guidelines