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Open AccessArticle

Outcomes of Chronic Phase Chronic Myeloid Leukemia after Treatment with Multiple Tyrosine Kinase Inhibitors

1
Department of Hematology Oncology, Division of Internal Medicine, Wonju Severance Christian Hospital, Yonsei College of Medicine, Wonju 26426, Korea
2
Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA 30322, USA
3
Section of Hematology and Oncology, Georgia Cancer Center at Augusta University, Augusta, GA 30912, USA
*
Author to whom correspondence should be addressed.
In memoriam.
J. Clin. Med. 2020, 9(5), 1542; https://doi.org/10.3390/jcm9051542
Received: 19 March 2020 / Revised: 17 April 2020 / Accepted: 13 May 2020 / Published: 20 May 2020
(This article belongs to the Special Issue Chronic Myeloid Leukemia: Diagnosis and Treatment)
We sought to evaluate the outcomes of chronic phase (CP) chronic myeloid leukemia (CML) in an era where five tyrosine kinase inhibitors (TKIs) are commercially available for the treatment of CML. Records of patients diagnosed with CP CML, treated with TKIs and referred to our center were reviewed. Between January 2005 and April 2016, 206 patients were followed for a median of 48.8 (1.4–190.1) months. A total of 76 (37%) patients received one TKI, 73 (35%) received two TKIs and 57 (28%) were exposed to >3 TKIs (3 TKIs, n = 33; 4 TKIs, n = 17; 5 TKIs, n = 7). Nineteen (9.2%) patients progressed to advanced phases of CML (accelerated phase, n = 6; myeloid blastic phase, n = 4; lymphoid blastic phase, n = 9). One third (n = 69) achieved complete molecular response (CMR) at first-line treatment. An additional 55 patients achieved CMR after second-line treatment. Twenty-five patients (12.1%) attempted TKI discontinuation and 14 (6.8%) stopped TKIs for a median of 6.3 months (range 1–53.4). The 10-year progression-free survival and overall survival (OS) rates were 81% and 87%, respectively. OS after 10-years, based on TKI exposure, was 100% (1 TKI), 82% (2 TKIs), 87% (3 TKIs), 75% (4 TKIs) and 55% (5 TKIs). The best OS was observed in patients tolerating and responding to first line TKI, but multiple TKIs led patients to gain treatment-free remission. View Full-Text
Keywords: chronic myeloid leukemia; chronic phase; tyrosine kinase inhibitor; survival rates; treatment-free remission chronic myeloid leukemia; chronic phase; tyrosine kinase inhibitor; survival rates; treatment-free remission
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Kong, J.H.; Winton, E.F.; Heffner, L.T.; Gaddh, M.; Hill, B.; Neely, J.; Hatcher, A.; Joseph, M.; Arellano, M.; El-Rassi, F.; Kim, A.; Khoury, J.H.; Kota, V.K. Outcomes of Chronic Phase Chronic Myeloid Leukemia after Treatment with Multiple Tyrosine Kinase Inhibitors. J. Clin. Med. 2020, 9, 1542.

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