Chronic Myeloid Leukemia is a disease whose prognosis and survival have significantly improved since the beginning of the use of tirosinkinase inhibitors (TKI). Achieving a sustained deep molecular response has lead to start succesful treatment suspension programs in other settings and stablished guidelines and recommendatios to carry out this suspension of TKI. The object of this work is to present a Real World data in a hospital in a developing country with limited resources. This kind of programs allow us to improved quality of life of patients, however, is mandatory a close follow up specially at the beginning to asses if a restart treatment is needed.
An observational, descriptive and retrospective study was performed collecting data from patients with Chronic Myeloid Leukemia (CML) registered at the data base of our institution.
At our hospital, from a cohort of 398 patients with diagnosis of CML between 1996 and 2024 registered in the data base, we performed a count of whom treatment was suspended. A total of 17 patients between 2016 and 2024 were found, 13 of them with medical indication for suspension of treatment, and 4 by own decision. At the time of discontinuation, the supervised group had an average disease duration of 7.04 years [4.89 - 11.83], while the other group had 8.16 years [3.78 - 10.49]. The following results were obtained: Of the 13 patients in protocol, 69.2% (9 patients) remained under observation without loss of molecular response. Of the 4 patients without treatment by their own decision, only 25% (1) remained under observation.
Besides, the average time to restart treatment due to loss of molecular response in the protocol group was 4.81 months [2.73 - 7 months), while for the unauthorized group it was 11.8 months [5.6 - 16.4 months]. At the time of completing the registry, the average treatment-free remission (TFR) time for the within-protocol group was 26.9 months, and 96 months for the only patient in the opposite group.
At our hospital, patients with Chronic Myeloid Leukemia who initiated treatment discontinuation within a protocol are a small population yet, although, doing so in a supervised setting generates better opportunities to maintained without therapy by a better selection of suitable patients. Furthermore, the results of this study allow us to keep this measure which is really usefull especially in countries with limited resources for diseases requiring long term therapies.
No relevant conflicts of interest to declare.
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