Vol 11, Supp. A (2020)
Case report
Published online: 2021-01-07

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Rapid molecular recurrence after nilotinib therapy cessation

Joanna Wącław1, Tomasz Sacha1

Abstract

Introduction of imatinib and then second-generation tyrosine kinase inhibitors (TKI) has resulted in the near-normal life expectancy of patients with chronic myeloid leukemia in chronic phase. Currently, treatment-free remission might be a therapeutic goal for a significant group of patients. Results of numerous clinical trials show that 40% up to 50% of patients who discontinue treatment after having achieved a stable deep molecular response (DMR) may remain treatment-free for an as-yet undefined period. It is important to underline that the patients with molecular relapse after discontinuation do not progress, and are almost all able to achieve DMR again upon retreatment. Here, we present a patient with CML, who was switched to nilotinib due to imatinib intolerance. After a few years of sustaining DMR nilotinib was stopped. 4 weeks after TKI discontinuation the patient lost major molecular response. Nilotinib was swiftly reintroduced and after 3 months the patient regained DMR.

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Hematology in Clinical Practice