Treatment-free remission in clinical practice: nilotinib treatment discontinuation in six chronic myelogenous leukemia patients — single-center experience

Abstract

In the last 20 years major goals of therapy of chronic myelogenous leukemia (CML) have changed. This leukemia, which was previously a fatal disease, has indeed become a chronic disease thanks to the use of tyrosine kinase inhibitors (TKIs), with life expectancy close to that in the general population. Excellent treatment effectiveness with the achievement of long-term, stable, deep molecular response was the motivation for attempts to stop the therapy with the intention of maintaining remission (TFR, treatment-free remission). Based on many clinical trials with over 3,000 patients and several years of follow-up, it is known that 40–60% of patients will maintain molecular remission and remain untreated, while the rest of them will require TKI to be restarted. Information on the procedure to be followed appeared in scientific societies’ recommendations and some centers treating CML patients have made attempts to stop the therapy. This work describes a group of six patients in the TFR phase after discontinuation of nilotinib used in the first-line treatment.