Chronic myeloid leukaemia remission stability after tyrosine - kinase inhibitors therapy cessation: a review of literature

Introduction: Chronic myeloid leukaemia (CML) is a specific malignant disease as it can be managed by a long-term oral tyrosine-kinase inhibitors (TKIs) treatment. Routine practise in the management of CML includes continuation of TKIs therapy even after the patient achieves remision. Several trials have demonstrated that TKIs discontinuation is feasible in clinical practice. The aim of this paper is to assess relevant scientific evidence on CML remission stability after TKIs therapy cessation. Methods: For systematic search, we used the MEDLINE/PubMed (National Library of medicine) Cochrane Central Register of Controlled Trials and Embase database. The last search update was on 31st December 2020. The search included observational cohort studies and randomized condrolled trials that evaluated treatment-free remission after TKIs therapy cessation. Results: A literature review provides data that patients with CML mostly achieve clinically feasible treatment free remission (TFR). The eleven studies incuded 1249 patients. After an average follow-up of 37 months (16 to 103), overall estimated TFR was 51% (35% to 64%). Conclusion: Evidence from reviewed studies indicated that discontinuation of TKIs is feasible and safe in the clinical practice.