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Lee, Sung-Eun; Choi, Soo Young; Song, Hye-Young; Kim, Soo-Hyun; Choi, Mi-Yeon; Park, Joon Seong; Kim, Hyeoung-Joon; Kim, Sung-Hyun; Zang, Dae Young; Oh, Sukjoong; Kim, Hawk; Do, Young Rok; Kwak, Jae-Yong; Kim, Jeong-A; Kim, Dae-Young; Mun, Yeung-Chul; Lee, Won Sik; Chang, Myung Hee; Park, Jinny; Kwon, Ji Hyun; Kim, Dong-Wook
Haematologica (Roma), 06/2016, Volume: 101, Issue: 6Journal Article
The aim of the Korean Imatinib Discontinuation Study was to identify predictors for safe and successful imatinib discontinuation. A total of 90 patients with a follow-up of ≥12 months were analyzed. After a median follow-up of 26.6 months after imatinib discontinuation, 37 patients lost the major molecular response. The probability of sustained major molecular response at 12 months and 24 months was 62.2% and 58.5%, respectively. All 37 patients who lost major molecular response were retreated with imatinib therapy for a median of 16.9 months, and all achieved major molecular response again at a median of 3.9 months after resuming imatinib therapy. We observed newly developed or worsened musculoskeletal pain and pruritus in 27 (30%) patients after imatinib discontinuation. Imatinib withdrawal syndrome was associated with a higher probability of sustained major molecular response (P=0.003) and showed a trend for a longer time to major molecular response loss (P=0.098). Positivity (defined as ≥ 17 positive chambers) of digital polymerase chain reaction at screening and longer imatinib duration before imatinib discontinuation were associated with a higher probability of sustained major molecular response. Our data demonstrated that the occurrence of imatinib withdrawal syndrome after imatinib discontinuation and longer duration of imatinib were associated with a lower rate of molecular relapse. In addition, minimal residual leukemia measured by digital polymerase chain reaction had a trend for a higher molecular relapse. (Trial registered at ClinicalTrials.gov: NCT01564836).
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