PDF(Pubmed)
Abstract：
With the discovery of tyrosine kinase inhibitors (TKIs), overall survival in patients with chronic myeloid leukemia (CML) now approaches that of the general population. While these TKIs have proven to be lifesaving, remaining on them lifelong creates both physical and financial burdens for patients. Recently, multiple trials have begun looking into the efficacy of trialing patients off these TKIs to see if they can sustain treatment-free remission (TFR). TFR eligibility is currently limited to a small population of patients with both robust and sustained responses to TKIs. Currently, for those who attempt a trial of TFR, the average success rates are promising, with anywhere from 38 to 54% of patients experiencing sustained TFR. For those who fail to maintain sustained TFR, safety results to date are reassuring, with almost all patients successfully responding to the re-initiation of TKIs, with death and disease progression being very rare complications. Moving forward, research is being conducted to more accurately risk stratify patients at diagnosis and pair them with optimized upfront treatment regimens aimed at increasing candidacy for the trial of TFR.
摘要：
随着酪氨酸激酶抑制剂（TKIs）的发现，慢性粒细胞白血病(CML)患者的总生存期目前接近普通人群.虽然这些TKIs被证明是救命的，终生留在他们身上会给患者带来身体和经济负担。最近,多项试验已经开始研究对这些TKIs患者进行试验的疗效,以观察他们是否能够维持无治疗缓解(TFR).TFR资格目前仅限于对TKIs具有稳健和持续反应的一小部分患者。目前,对于那些试图审判TFR的人来说，平均成功率很有希望，有38％至54％的患者经历持续的TFR。对于那些无法保持持续TFR的人，迄今为止的安全结果令人放心，几乎所有患者都成功地对TKIs的重新开始作出反应，死亡和疾病进展是非常罕见的并发症。往前走,目前正在进行研究,以便在诊断时更准确地对患者进行风险分层,并将其与旨在提高TFR试验候选资格的优化前期治疗方案配对.
