Opportunities of Chronic Myeloid Leukemia Treatment with Reduced Doses of Tyrosine Kinase Inhibitors

AUTOIMMUNE THROMBOCYTOPENIA , ,

MA Guryanova, EYu Chelysheva, AG Turkina

National Research Center for Hematology, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167

For correspondence: Margarita Anatolevna Guryanova, 4 Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167; Tel.: +7(985)201-70-40; e-mail: margarita.samtcova@yandex.ru

For citation: Guryanova MA, Chelysheva EYu, Turkina AG. Opportunities of Chronic Myeloid Leukemia Treatment with Reduced Doses of Tyrosine Kinase Inhibitors. Clinical oncohematology. 2021;14(1):118–28. (In Russ).

DOI: 10.21320/2500-2139-2021-14-1-118-128

ABSTRACT

Tyrosine kinase inhibitor (TKI) therapy results in deep molecular response (MR) in 60–70 % of chronic myeloid leukemia (CML) patients. However, despite high efficacy of TKIs, many patients experience drug toxicity during the treatment. According to clinical studies, the probability of sustaining off-treatment remission in CML patients with deep MR is about 40–60 %. Great attention has recently been paid to personalized therapy of chronic phase CML. It consists in TKI dose modification to reduce or prevent adverse events. Major retrospective studies proved that in patients with optimal response TKI reduced doses can be considered safe from the point of view of sustaining major and deep MRs achieved with standard TKI doses. Also, prospective clinical trials deal with the follow-up using TKI reduced doses as pre-withdrawal period. But up to now, the results of only 4 of such studies have been available. To take a closer look at long-term follow-up of CML patients receiving reduced doses of TKIs, prospective clinical trials need to be carried out. The present article reviews the results of main studies dealing with management of CML patients treated with TKI reduced doses.

Keywords: chronic myeloid leukemia, tyrosine kinase inhibitors, major molecular response, deep molecular response, adverse events, pharmacokinetics of tyrosine kinase inhibitors.

Received: August 3, 2020

Accepted: November 20, 2020

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Статистика Plumx английский

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