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Chronic Myeloid Leukemia—the Promise of Tyrosine Kinase Inhibitor Discontinuation

  • Myeloproliferative Neoplasms (B Stein, Section Editor)
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Abstract

Some believe that tyrosine kinase inhibitor (TKI) therapy is as close to perfect as it gets in oncologic therapy. Patients diagnosed with chronic myeloid leukemia (CML) are treated with a daily oral therapy, through which most achieve remission. TKI therapy is not associated with classic chemotherapy side effects, and most patients are able to resume their normal activities of daily living. Moreover, recent data has demonstrated that CML does not affect the life expectancy of patients whose disease is well controlled with a TKI. However, TKI therapy is actually not that perfect. Patients need to stay on therapy forever. They have to remember to take their medications daily. TKIs are expensive, and the financial burden to patient and society cannot be overstated. Most patients’ health-related quality of life is affected; common side effects include fatigue, muscle cramps, pain, edema, skin problems, and gastrointestinal symptoms. In addition, concerns about long-term side effects remain. Recently several studies have shown the feasibility and safety of discontinuation in a select group of patients. Herein, we will review the currently available data on stopping TKIs in CML.

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Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA

    Ravi Kishore Narra & Ehab Atallah

  2. Center for Patient Care and Outcomes Research, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA

    Kathryn E. Flynn

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  1. Ravi Kishore Narra
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Correspondence to Ehab Atallah.

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Ravi Kishore Narra and Kathryn E. Flynn each declare no potential conflicts of interest.

Ehab Atallah reports personal fees from BMS, personal fees from Novartis, personal fees from Pfizer, and personal fees from Ariad outside the submitted work.

This paper was partly supported by NIH grant 1R01CA184798

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This article contains no studies with human or animal subjects performed by any of the authors.

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Narra, R.K., Flynn, K.E. & Atallah, E. Chronic Myeloid Leukemia—the Promise of Tyrosine Kinase Inhibitor Discontinuation. Curr Hematol Malig Rep 12, 415–423 (2017). https://doi.org/10.1007/s11899-017-0404-z

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