Journal of the National Comprehensive Cancer Network : JNCCN · 2026
Real-World Evidence-Based Study on Treatment-Free Remission in Chronic Myeloid Leukemia.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cheng Fang, Wang Yu, Zhu Yu, Yang Yunfan, Weng Jianyu, Xu Na, Huang Jian, Liu Zhenfang, Ren Hongbo, Zhao Huifang, Zhu Huanling, Ke Yajuan, Wu Weiyan, Du Xin, Jiang Qian, Zhang Yanli, Li Weiming
Аннотация
BACKGROUND: Treatment-free remission (TFR) has become a treatment goal for chronic myeloid leukemia (CML). This study aimed to define precise conditions for treatment discontinuation and to develop TFR prediction models in a Chinese population.
PATIENTS AND METHODS: This study collected data from 11 centers involving 802 cases of tyrosine kinase inhibitor (TKI) discontinuation in patients with CML. Eligible patients had received any TKI for at least 3 years and had maintained a deep molecular response (DMR) for at least 2 years. The primary endpoint was maintenance of major molecular response (MMR) within 12 months after discontinuation.
RESULTS: Among 698 eligible patients (459 in the learning cohort and 239 in the validation cohort), 318 (45.6%) lost MMR, most commonly within the first 6 months after discontinuation (234/318; 73.6%). TFR rates were 66.5% at 6 months, 57.7% at 12 months, and 55.5% at 24 months. All patients regained MMR/DMR upon TKI reinitiation, with no disease progression. Longer treatment duration and sustained DMR were associated with higher TFR rates for both imatinib and second-generation TKIs. Superior outcomes correlated with low Sokal risk, no resistance, ≥5 years of TKI therapy, optimal DMR duration, and achievement of MMR at 12 months. The rate of sustained TFR was 73.5%, 60.0%, 44.6%, and 20.6% for patients with 0, 1, 2, and ≥3 nonoptimal factors, respectively. We developed predictive models and created a web-based calculator to assist clinicians in decision-making.
CONCLUSIONS: Patients achieving durable DMR can safely discontinue therapy with rigorous monitoring. TFR attempts remain viable even under nonoptimal conditions, provided that adequate DMR duration and close monitoring are maintained.
PATIENTS AND METHODS: This study collected data from 11 centers involving 802 cases of tyrosine kinase inhibitor (TKI) discontinuation in patients with CML. Eligible patients had received any TKI for at least 3 years and had maintained a deep molecular response (DMR) for at least 2 years. The primary endpoint was maintenance of major molecular response (MMR) within 12 months after discontinuation.
RESULTS: Among 698 eligible patients (459 in the learning cohort and 239 in the validation cohort), 318 (45.6%) lost MMR, most commonly within the first 6 months after discontinuation (234/318; 73.6%). TFR rates were 66.5% at 6 months, 57.7% at 12 months, and 55.5% at 24 months. All patients regained MMR/DMR upon TKI reinitiation, with no disease progression. Longer treatment duration and sustained DMR were associated with higher TFR rates for both imatinib and second-generation TKIs. Superior outcomes correlated with low Sokal risk, no resistance, ≥5 years of TKI therapy, optimal DMR duration, and achievement of MMR at 12 months. The rate of sustained TFR was 73.5%, 60.0%, 44.6%, and 20.6% for patients with 0, 1, 2, and ≥3 nonoptimal factors, respectively. We developed predictive models and created a web-based calculator to assist clinicians in decision-making.
CONCLUSIONS: Patients achieving durable DMR can safely discontinue therapy with rigorous monitoring. TFR attempts remain viable even under nonoptimal conditions, provided that adequate DMR duration and close monitoring are maintained.