Considerations for Treatment-free Remission in Patients With Chronic Myeloid Leukemia: A Joint Patient-Physician Perspective
Language English Country United States Media print-electronic
Document type Journal Article, Review
PubMed
29753691
DOI
10.1016/j.clml.2018.04.005
PII: S2152-2650(18)30385-9
Knihovny.cz E-resources
- Keywords
- CML, CML advocates, TFR, TKIs (Tyrosine Kinase Inhibitors), Therapy discontinuation,
- MeSH
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy mortality MeSH
- Remission Induction methods MeSH
- Protein Kinase Inhibitors pharmacology therapeutic use MeSH
- Quality of Life MeSH
- Humans MeSH
- Neoplasm Recurrence, Local prevention & control MeSH
- Survival Rate MeSH
- Withholding Treatment * MeSH
- Decision Making MeSH
- Protein-Tyrosine Kinases antagonists & inhibitors MeSH
- Treatment Outcome MeSH
- Patient Education as Topic MeSH
- Physician-Patient Relations * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Names of Substances
- Protein Kinase Inhibitors MeSH
- Protein-Tyrosine Kinases MeSH
Treatment-free remission (TFR) after discontinuation of tyrosine kinase inhibitor therapy is now an emerging treatment goal for patients with chronic myeloid leukemia, who have achieved a deep and stable response to treatment. Although guidance is now available, patients' questions regarding this progressive concept have yet to be addressed. The overall aim of this European Steering Group is a patient-centered approach that educates patients on their treatment options, including TFR, facilitates better patient-physician relationships, and meets patients' emotional and psychological needs. The present report outlines 5 key topic areas on discontinuing tyrosine kinase therapy and the implications of TFR for patient-physician consideration: what TFR is; when TFR is appropriate; which patients might and might not be eligible for TFR; and patients' considerations for discontinuing therapy, such as tyrosine kinase withdrawal syndrome, potential psychological implications, molecular recurrence, and repeat treatment. This Steering Group advocates that patients with chronic myeloid leukemia should have access to high-quality, frequent molecular monitoring and be treated in a specialist center with appropriate medical and psychological support. As patient concerns with attempting TFR become forefront in patient-physician discussions, a greater number of eligible patients might be willing to discontinue therapy.
Albert Schweitzer Hospital Dordrecht The Netherlands
Clinical Centre of Serbia University of Belgrade School of Medicine Belgrade Serbia
CML Advocates Network Netanya Israel
CML Association of Serbia Belgrade Serbia
CML UK Birmingham United Kingdom
Department of Clinical and Biological Sciences University of Turin Turin Italy
Department of Internal Medicine Hematology and Oncology University Hospital Brno Brno Czech Republic
Gruppo AIL Pazienti Leucemia Mieloide Cronica Rome Italy
Hematon Foundation Utrecht The Netherlands
Hospital da Luz Lisbon Portugal
Hospital Universitario Ramón y Cajal Ramón y Cajal Health Research Institute Madrid Spain
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