Author(s):
Cerveira, Nuno ; Diamond, Joana ; Matos, Sónia ; Amorim, Maria L ; Coucelo, Margarida ; Bizarro, Susana ; Simões, Ana Teresa ; Pierdomenico, Francesca ; Lopes, Mariana ; Ribeiro, Letícia ; Carmo-Fonseca, Maria ; Guimarães, José E ; Almeida, António ; Teixeira, Manuel R
Date: 2019
Persistent ID: http://hdl.handle.net/10451/49215
Origin: Repositório da Universidade de Lisboa
Subject(s): Chronic myeloid leukaemia; Treatment-free remission; Molecular response level; qRT-PCR; MR4.0 negative
Description
ABL1 tyrosine kinase inhibitors (TKI) have dramatically improved the outcome for chronic myeloid leukaemia (CML) patients, resulting in a life expectancy that approaches that of the general population. Nevertheless, lifelong TKI therapy may have consequences, including chronic adverse events that can substantially impact patients’ quality of life, adherence to therapy and treatment success. Recently, several clinical discontinuation trials have demonstrated that 40–60% of chronic phase CML patients (CP-CML) who have achieved a stable deep molecular response (DMR) can stop therapy without relapsing (Breccia & Foà, 2018). Laboratory recommendations for scoring DMR were previously defined as MR4·0 [either detectable disease ⩽0·01% BCR-ABLIS (MR4·0 positive) or undetectable disease in cDNA with 10 000–31 999 ABL1 transcripts or 24 000–76 999 GUSB transcripts (MR4·0 negative)], MR4·5 [either detectable disease ⩽0·0032% BCR-ABLIS (MR4·5 positive) or undetectable disease in cDNA with 32 000–99 999 ABL1 transcripts or 77 000–239 999 GUSB transcripts (MR4·5 negative)], and MR5·0 [either detectable disease ⩽0·001% BCR-ABLIS (MR5·0 positive) or undetectable disease in cDNA with ⩾100 000 ABL1 transcripts or ⩾240 000 GUSB transcripts (MR5·0 negative)] (Cross et al, 2015).
