Patient-Initiated Discontinuation of Tyrosine Kinase Inhibitor for Chronic Myeloid Leukemia
The introduction of tyrosine kinase inhibitors (TKI) has revolutionised the management of patients with chronic myeloid leukemia (CML) over the last twenty years, but despite significant improvements in survival, patients exhibit long-term side effects that impact on quality of life. A major advance...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2020/9571691 |
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| author | Stephen E. Langabeer Rehman Faryal Michael O’Dwyer Sorcha Ní Loingsigh |
| author_facet | Stephen E. Langabeer Rehman Faryal Michael O’Dwyer Sorcha Ní Loingsigh |
| author_sort | Stephen E. Langabeer |
| collection | DOAJ |
| description | The introduction of tyrosine kinase inhibitors (TKI) has revolutionised the management of patients with chronic myeloid leukemia (CML) over the last twenty years, but despite significant improvements in survival, patients exhibit long-term side effects that impact on quality of life. A major advance in CML management has been the ability to discontinue TKI therapy achieving a treatment-free remission (TFR), yet this option is only available to eligible patients who present with low-risk disease and who subsequently attain deep and sustained molecular responses. A case is described of a patient with CML who self-initiated stopping of TKI therapy when in a less than optimal molecular remission. Despite this action, the patient continues to experience a TFR with prospective close molecular monitoring performed. It is emphasized that this approach may lead to ineffective treatment discontinuation, molecular relapse, and increased patient anxiety. As TFR for patients with CML moves from clinical trials into routine clinical practice, emphasis is placed on adherence to (evolving) guidelines critical to ensure optimal counselling, selection, monitoring, and continued management of patients whether TFR is successful or not. |
| format | Article |
| id | doaj-art-02131a6808784dd695dee22c542ef7ad |
| institution | OA Journals |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-02131a6808784dd695dee22c542ef7ad2025-08-20T02:01:46ZengWileyCase Reports in Hematology2090-65602090-65792020-01-01202010.1155/2020/95716919571691Patient-Initiated Discontinuation of Tyrosine Kinase Inhibitor for Chronic Myeloid LeukemiaStephen E. Langabeer0Rehman Faryal1Michael O’Dwyer2Sorcha Ní Loingsigh3Cancer Molecular Diagnostics, St. James’s Hospital, Dublin D08 W9RT, IrelandDepartment of Haematology, University Hospital Galway, Galway H91 YR71, IrelandDepartment of Haematology, University Hospital Galway, Galway H91 YR71, IrelandDepartment of Haematology, University Hospital Galway, Galway H91 YR71, IrelandThe introduction of tyrosine kinase inhibitors (TKI) has revolutionised the management of patients with chronic myeloid leukemia (CML) over the last twenty years, but despite significant improvements in survival, patients exhibit long-term side effects that impact on quality of life. A major advance in CML management has been the ability to discontinue TKI therapy achieving a treatment-free remission (TFR), yet this option is only available to eligible patients who present with low-risk disease and who subsequently attain deep and sustained molecular responses. A case is described of a patient with CML who self-initiated stopping of TKI therapy when in a less than optimal molecular remission. Despite this action, the patient continues to experience a TFR with prospective close molecular monitoring performed. It is emphasized that this approach may lead to ineffective treatment discontinuation, molecular relapse, and increased patient anxiety. As TFR for patients with CML moves from clinical trials into routine clinical practice, emphasis is placed on adherence to (evolving) guidelines critical to ensure optimal counselling, selection, monitoring, and continued management of patients whether TFR is successful or not.http://dx.doi.org/10.1155/2020/9571691 |
| spellingShingle | Stephen E. Langabeer Rehman Faryal Michael O’Dwyer Sorcha Ní Loingsigh Patient-Initiated Discontinuation of Tyrosine Kinase Inhibitor for Chronic Myeloid Leukemia Case Reports in Hematology |
| title | Patient-Initiated Discontinuation of Tyrosine Kinase Inhibitor for Chronic Myeloid Leukemia |
| title_full | Patient-Initiated Discontinuation of Tyrosine Kinase Inhibitor for Chronic Myeloid Leukemia |
| title_fullStr | Patient-Initiated Discontinuation of Tyrosine Kinase Inhibitor for Chronic Myeloid Leukemia |
| title_full_unstemmed | Patient-Initiated Discontinuation of Tyrosine Kinase Inhibitor for Chronic Myeloid Leukemia |
| title_short | Patient-Initiated Discontinuation of Tyrosine Kinase Inhibitor for Chronic Myeloid Leukemia |
| title_sort | patient initiated discontinuation of tyrosine kinase inhibitor for chronic myeloid leukemia |
| url | http://dx.doi.org/10.1155/2020/9571691 |
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