A Retrospective Analysis about Frequency of Monitoring in Italian Chronic Myeloid Leukemia Patients after Discontinuation

Dragani, Matteo;Rege Cambrin, Giovanna;Berchialla, Paola;Dogliotti, Irene;Rosti, Gianantonio;Castagnetti, Fausto;Capodanno, Isabella;Martino, Bruno;Cerrano, Marco;Ferrero, Dario;Gambacorti-Passerini, Carlo;Crugnola, Monica;Elena, Chiara;Breccia, Massimo;Iurlo, Alessandra;Cattaneo, Daniele;Galimberti, Sara;Gozzini, Antonella;Bocchia, Monica;Lunghi, Francesca;Cedrone, Michele;Sgherza, Nicola;Luciano, Luigia;Russo, Sabina;Santoro, Marco;Giai, Valentina;Caocci, Giovanni;Levato, Luciano;Abruzzese, Elisabetta;Sora, Federica;Saglio, Giuseppe;Fava, Carmen

2020-01-01

---

Abstract

Successful discontinuation of tyrosine kinase inhibitors has been achieved in patients with chronic-phase chronic myeloid leukemia (CML). Careful molecular monitoring after discontinuation warrants safe and prompt resumption of therapy. We retrospectively evaluated how molecular monitoring has been conducted in Italy in a cohort of patients who discontinued tyrosine kinase inhibitor (TKI) treatment per clinical practice. The outcome of these patients has recently been reported-281 chronic-phase CML patients were included in this subanalysis. Median follow-up since discontinuation was 2 years. Overall, 2203 analyses were performed, 17.9% in the first three months and 38.4% in the first six months. Eighty-six patients lost major molecular response (MMR) in a mean time of 5.7 months-65 pts (75.6%) during the first six months. We evaluated the number of patients who would experience a delay in diagnosis of MMR loss if a three-month monitoring schedule was adopted. In the first 6 months, 19 pts (29.2%) would have a one-month delay, 26 (40%) a 2-month delay. Very few patients would experience a delay in the following months. A less intense frequency of monitoring, particularly after the first 6 months off treatment, would not have affected the success of treatment-free remission (TFR) nor put patients at risk of progression.