Chronic Myeloid Leukemia Coverage from Every Angle

Prognostic Factors for Molecular Relapse–Free Survival in CML

By: Julia Fiederlein
Posted: Monday, October 12, 2020

Oleg A. Shukhov, MD, PhD, of the National Research Center for Hematology, Moscow, and colleagues conducted a multicenter prospective study to define the prognostic factors for molecular relapse–free survival in Russian patients with chronic myeloid leukemia (CML) after the discontinuation of tyrosine kinase inhibitor therapy. The RU-SKI trial results were presented during the virtual edition of the 2020 Society of Hematologic Oncology (SOHO) Annual Meeting (Abstract CML-083).

A total of 98 patients with chronic-phase CML who received imatinib (68.4%), a first-line second-generation tyrosine kinase inhibitor (10.2%), or a second-line second-generation tyrosine kinase inhibitor (21.4%) for at least 3 years took part in the study. To be enrolled, they were required to have had a stable deep molecular response (defined as a BCR-ABL transcript level of less than 0.01%) for at least 2 years.

In all groups, the 3-year molecular relapse–free survival rate was 51%. According to the investigators, the molecular relapse–free survival rate was 25% in patients with a history of treatment-free remission failure. The length of deep molecular response, duration of therapy, and depth of molecular response seemed to be prognostic for molecular relapse–free survival (P ≤ .05). The duration of tyrosine kinase inhibitor therapy appeared to be independently prognostic in this patient population; however, this did not seem to hold true for the duration of deep molecular response.

The 36-month molecular relapse–free survival rate observed with first-line imatinib (55%) did not appear to significantly differ from those observed with first-line second-generation tyrosine kinase inhibitors (70%; P = .26) and second-line second-generation tyrosine kinase inhibitors (39%; P = .09); however, treatment with first-line second-generation tyrosine kinase inhibitors seemed to result in a significantly shorter treatment duration compared with imatinib (41.5 vs. 96.4 months; P < .0001).  

Disclosure: No information regarding conflicts of interest was provided.

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