Cytogenetic and Molecular Failure at 12 Months will be the Optimal Time Point for BCR-ABL1 Tyrosine Kinase Domain Mutation Analysis in Patients with Chronic Myeloid Leukemia: The Analysis Based on 2013 European LeukemiaNet Recommendation
BCR-ABL1 kinase domain mutations are closely related to tyrosine kinase inhibitor (TKI) resistance in chronic myeloid leukemia (CML). Although mutation analysis has been recommended in CML patients with treatment failure, there is no standard guideline according to landmark responses at specific timepoints of European LeukemiaNet (ELN) recommendation.
Treatment-free remission after discontinuation of tyrosine kinase inhibitor therapy is now an emerging treatment goal in patients with chronic myeloid leukemia, who have achieved a deep and stable response to treatment. While guidance are now available, considering patients ’ questions on this progressive concept have yet to be addressed. The overall aim of this European Steering Group is a patient-centered approach that educates patients on their treatment options, including treatment-free remission, facilitates better patient-physician relationships, and meets pati ents’ emotional and psychological needs.
CONCLUSIONS: Our analysis provided no convincing evidence for an increased risk of death from a range of hematolymphopoietic cancers in workers exposed to high or medium levels of ELF magnetic fields. However, we observed an increased risk of acute myeloid leukaemia in workers exposed to high levels for a longer duration. Observed risks are in line with meta-analysed previous reports on ELF-MF exposure and AML risk, with a summary relative risk of 1.21 (95%CI 1.08-1.37). PMID: 29587222 [PubMed - as supplied by publisher]
Conclusion These findings suggest that discontinuation of second- or subsequent-line dasatinib after a sustained DMR of at least 1 year is feasible, particularly for patients with no prior history of imatinib resistance. In addition, the NK cell count was associated with TFR. (DADI trial; UMIN000005130).
Conclusion After a median follow-up of 8 years, imatinib was found to induce long survival with manageable side effect in adult Saudi patients with CML-CP. Micro-Abstract Imatinib (Gleevec) was the first drug to target the breakpoint cluster region (BCR)-Abelson (ABL) tyrosine kinase and hence became the first line of therapy for patients with chronic myeloid leukemia. It provides a high rate of remission and survival benefits with minimal side effects.
Conclusion In this study, we investigated the effect of pharmacogenetics in the context of a CML treatment discontinuation trial. The transcript levels of the efflux transporter ABCG2 predicted TFR after TKI discontinuation. Micro-Abstract Whithin the EURO-SKI trial, 132 chronic phase CML patients discontinued imatinib treatment. RNA was isolated from peripheral blood in order to analyze the expression of MDR1, ABCG2 and OCT1. ABCG2 was predictive for treatment-free remission in Cox regression analysis. High transcript levels of the ABCG2 efflux transporter (>4.5‰) were associated with a twofold higher risk of relapse.
We previously reported an interim analysis of the Dasatinib Discontinuation (DADI) trial. The results showed that 48% of patients with chronic myeloid leukemia in chronic phase (CML-CP) who maintained a deep molecular response (DMR) for at least 1 year could discontinue second- or subsequent-line dasatinib treatment safely at a median follow-up of 20 months. However, the results of longer follow-up would be much more useful from a clinical perspective.
CONCLUSIONS: - Nonmesothelial neoplasms are uncommon in individuals with MM, but certain tumor types are increased in prevalence. In an unselected study population with respect to BAP1 status, the prevalence of several tumor types described in BAP1 mutation carriers, including lung carcinoma, clear cell renal cell carcinoma, breast carcinoma, meningioma, pleomorphic undifferentiated sarcoma, and ocular melanoma, was increased. PMID: 29528717 [PubMed - as supplied by publisher]
Tyrosine kinase inhibitors (TKIs) can safely be discontinued in chronic myeloid leukemia (CML) patients with sustained deep molecular response (DMR). ABCG2, OCT1 and ABCB1 (MDR1) gene products are known to play a crucial role in acquired pharmacogenetic TKI resistance. Their influence on treatment-free remission (TFR) has not yet been investigated.
In this study, we assessed the efficacy and toxicity of imatinib therapy in patients with chronic myeloid leukemia in chronic phase (CML-CP) in our hospital.
CONCLUSION: After a median follow-up of 8 years, imatinib was found to induce long survival with manageable side effect in adult Saudi patients with CML-CP. PMID: 29397347 [PubMed - as supplied by publisher]