Sustained deep molecular response over eight years after discontinuation of imatinib for chronic myeloid leukemia

[Rinshō ketsueki] The Japanese journal of clinical hematology
Hina TakanoAtsushi Kato

Abstract

A 72-year-old female was diagnosed with chronic phase chronic myeloid leukemia (CML) in 2001. After a short course of treatment with hydroxycarbamide, imatinib (IM) 400 mg was started. A major molecular response was presumably acquired 10 months later. IM was discontinued after treatment for 47 months in November 2005. At the same time, BCR-ABL transcript was undetectable by nested RT-PCR assay, which was equivalent to <0.00138% BCR-ABL according to the international scale. The patient is still under observation with no additional therapy, and BCR-ABL has remained negative for 102 months, to date. Furthermore, interferon was never used in this patient. IM has dramatically improved the prognosis of CML. Since no cure has yet been established, patients are recommended to continue treatment even after achieving deep molecular responses. There are several ongoing clinical trials challenging the discontinuation of IM, but long-term observation is still lacking. The sustained deep molecular response, exceeding eight years, experienced in this patient is potentially encouraging.

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