Brazilian chronic myeloid leukemia working group recommendations for discontinuation of tyrosine kinase inhibitors in chronic myeloid leukemia in clinical practice
Hematol., Transfus. Cell Ther. (Impr.)
;
44(3): 402-409, July-Sept. 2022. tab, ilus
Article
in English
| LILACS
| ID: biblio-1405002
ABSTRACT
ABSTRACT Introduction:
Treatment-free remission (TFR) is a new goal of chronic myeloid leukemia (CML) therapy. TFR is feasible when the patient has achieved a deep and stable molecular response and met the criteria required to ensure its success. Treatment discontinuation should not be proposed to the CML patient if minimum conditions are not met. In Brazil, for example, molecular tests (BCRABL1) are not broadly available, making it difficult to monitor the patients adequately.Objective:
In this sense, providing TFR recommendations for Brazilian physicians are therefore necessary. These recommendations include the main criteria checklist to start the TKIs treatment discontinuing process in patients diagnosed with CML and the population-eligible characteristics for treatment discontinuation.Method:
Age, risk score at diagnosis, TKI treatment duration, BCRABL1 transcripts type, depth of the molecular response for treatment discontinuation, treatment adherence, patient monitoring and withdrawal syndrome are essential factors to consider in TFR. After TKI discontinuation, BCRABL1 transcripts monitoring should be more frequent. When a major molecular response loss is observed during the monitoring of a patient in TFR, the TKI treatment should be resumed.Conclusion:
These recommendations should serve as a basis for medical professionals interested in proposing TKI discontinuation for CML patients in clinical practice. It is important to highlight that, despite the benefits of TFR for the patients and the health system, it should only be feasible following the minimum standards proposed in this recommendation.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Protein-Tyrosine Kinases
/
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Type of study:
Practice guideline
Limits:
Adult
/
Aged
/
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Hematol., Transfus. Cell Ther. (Impr.)
Journal subject:
Hematologia
/
TransfusÆo de Sangue
Year:
2022
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Centro de Pesquisas Oncologicas - CEPON/BR
/
Instituto COI/BR
/
Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti - HEMORIO/BR
/
Instituto Hemomed de Oncologia e Hematologia/BR
/
Universidade Estadual de Campinas - UNICAMP/BR
/
Universidade Federal de Minas Gerais - UFMG/BR
/
Universidade Federal do Parana - UFPR/BR
/
Universidade de São Paulo - USP/BR
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