Michel, Christian and Burchert, Andreas and Hochhaus, Andreas and Saussele, Susanne and Neubauer, Andreas and Lauseker, Michael and Krause, Stefan W. and Kolb, Hans-Jochem and Hossfeld, Dieter Kurt and Nerl, Christoph and Baerlocher, Gabriela M. and Heim, Dominik and Bruemmendorf, Tim H. and Fabarius, Alice and Haferlach, Claudia and Schlegelberger, Brigitte and Balleisen, Leopold and Goebeler, Maria-Elisabeth and Haenel, Mathias and Ho, Anthony and Dengler, Jolanta and Falge, Christiane and Moehle, Robert and Kremers, Stephan and Kneba, Michael and Stegelmann, Frank and Koehne, Claus-Henning and Lindemann, Hans-Walter and Waller, Cornelius F. and Spiekermann, Karsten and Berdel, Wolfgang E. and Mueller, Lothar and Edinger, Matthias and Mayer, Jiri and Beelen, Dietrich W. and Bentz, Martin and Link, Hartmut and Hertenstein, Bernd and Fuchs, Roland and Wernli, Martin and Schlegel, Frank and Schlag, Rudolf and de Wit, Maike and Truemper, Lorenz and Hebart, Holger and Hahn, Markus and Thomalla, Joerg and Scheid, Christof and Schafhausen, Philippe and Verbeek, Walter and Eckart, Michael J. and Gassmann, Winfried and Schenk, Michael and Brossart, Peter and Wuendisch, Thomas and Geer, Thomas and Bildat, Stephan and Schaefer, Erhardt and Hasford, Joerg and Hehlmann, Ruediger and Pfirrmann, Markus (2019) Imatinib dose reduction in major molecular response of chronic myeloid leukemia: results from the German Chronic Myeloid Leukemia-Study IV. HAEMATOLOGICA, 104 (5). pp. 955-962. ISSN 0390-6078,
Full text not available from this repository. (Request a copy)Abstract
Standard first-line therapy of chronic myeloid leukemia is treatment with imatinib. In the randomized German Chronic Myeloid Leukemia-Study IV, more potent BCR-ABL inhibition with 800 mg ('high-dose') imatinib accelerated achievement of a deep molecular remission. However, whether and when a de-escalation of the dose intensity under high-dose imatinib can be safely performed without increasing the risk of losing deep molecular response is unknown. To gain insights into this clinically relevant question, we analyzed the outcome of imatinib dose reductions from 800 mg to 400 mg daily in the Chronic Myeloid Leukemia-Study IV. Of the 422 patients that were randomized to the 800 mg arm, 68 reduced imatinib to 400 mg after they had achieved at least a stable major molecular response. Of these 68 patients, 61 (90%) maintained major molecular remission on imatinib at 400 mg. Five of the seven patients who lost major molecular remission on the imatinib standard dose regained major molecular remission while still on 400 mg imatinib. Only two of 68 patients had to switch to more potent kinase inhibition to regain major molecular remission. Importantly, the lengths of the intervals between imatinib high-dose treatment before and after achieving major molecular remission were associated with the probabilities of maintaining major molecular remission with the standard dose of imatinib. Taken together, the data support the view that a deep molecular remission achieved with high-dose imatinib can be safely maintained with standard dose in most patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CHRONIC MYELOGENOUS LEUKEMIA; TREATMENT-FREE REMISSION; QUALITY-OF-LIFE; CHRONIC-PHASE; RANDOMIZED CML; SURVIVAL; DASATINIB; NILOTINIB; THERAPY; 5-YEAR; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Apr 2020 04:43 |
| Last Modified: | 14 Apr 2020 04:43 |
| URI: | https://pred.uni-regensburg.de/id/eprint/27134 |
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