仅临床因素并不能使我们区分哪些患者将维持无治疗缓解(TFR)与可能复发的患者。因此,患者特定因素也必须发挥作用。这篇综述将使读者了解最新的研究,这些研究提出了可以帮助预测酪氨酸激酶抑制剂(TKI)停药成功的生物学因素。
在TFR中具有建议作用的细胞和分子因子包括免疫因子和白血病干细胞(LSC)持久性;BCR::ABL1转录本类型,减半时间,和BCR::ABL1DNA和RNA阳性;以及其他分子因素,如体细胞突变,RNA表达,和端粒长度。我们的综述提出了几种对TFR具有预测价值的生物标志物,但也强调了未满足需求的领域。未来的停药指南可能会包括用于TFR预测个性化的生物学因素。然而,重要的是,这些进展不能阻止更多患者尝试停用TKI.
Clinical factors alone do not enable us to differentiate which patients will maintain treatment-free remission (TFR) from those who are likely to relapse. Thus, patient-specific factors must also play a role. This
review will update the reader on the most recent studies presenting biological factors that can help predict tyrosine kinase inhibitor (TKI) discontinuation success.
Cellular and molecular factors with a suggested role in TFR include immune factors and leukemic stem cell (LSC) persistence; the BCR::ABL1 transcript type, halving time, and BCR::ABL1 DNA and RNA positivity; as well as other molecular factors such as somatic mutations, RNA expression, and telomere length. Our
review presents several biomarkers with predictive value for TFR but also highlights areas of unmet need. Future discontinuation guidelines will likely include biological factors for the personalization of TFR prediction. However, it will be important that such advances do not prevent more patients from making a TKI discontinuation attempt.