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Imatinib withdrawal syndrome and longer duration of imatinib have a close association with a lower molecular relapse after treatment discontinuation: the KID study

2016; Ferrata Storti Foundation; Volume: 101; Issue: 6 Linguagem: Inglês

10.3324/haematol.2015.139899

1592-8721

S.-E. Lee, Soo Young Choi, Ho Young Song, S H Kim, M.-Y. Choi, J. S. Park, H.-J. Kim, S.-H. Kim, Dae Young Zang, Subi Oh, H. Kim, Yashica Gowda R, Jae‐Yong Kwak, Jeong‐Ah Kim, D.-Y. Kim, Yeung‐Chul Mun, W. S. Lee, Myung Hee Chang, Jinny Park, J. H. Kwon, D.-W. Kim,

Lymphoma Diagnosis and Treatment

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).