When is discontinuation of TKI therapy considered in the treatment of chronic myelogenous leukemia (CML)?

Updated: Oct 23, 2019
  • Author: Rossa Khalaf, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

Several studies have demonstrated that discontinuation of TKI therapy is feasible in very carefully selected patients, after the desired response has been achieved and BCR-ABL1 transcripts have become clinically undetectable. Approximately 40%-60% of those patients relapse within 6 months, but typically, all patients who have relapsed respond to resumption of TKI therapy. [32, 33, 34] However, discontinuation of TKIs is associated with significant adverse events (eg, musculoskeletal pain) in some patients. [34, 19]

Resumptions of imatinib treatment immediately after recurrence has achieved undetectable minimal residual disease; similar results have also been reported for other TKI therapy .However, very strict criteria were used and if discontinuation of TKI is desired, then all these criteria should be met and meticulous follow-up recommended. [19, 32]


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