Imatinib mesylate discontinuation in patients with chronic myelogenous leukemia in complete molecular remission for more than 2 years

P Rousselot, F Huguet, D Rea, L Legros, JM Cayuela… - Blood, 2007 - ashpublications.org
P Rousselot, F Huguet, D Rea, L Legros, JM Cayuela, O Maarek, O Blanchet, G Marit…
Blood, 2007ashpublications.org
In the present study, we address the issue of the discontinuation of imatinib mesylate
(Gleevec) in chronic myelogenous leukemia with undetectable residual disease for more
than 2 years. Twelve patients were included. The median duration of real-time quantitative–
polymerase chain reaction (RTQ-PCR) negativity and imatinib therapy were, respectively, 32
months (range, 24-46 months) and 45 months (range, 32-56 months) before imatinib
interruption. Six patients displayed a molecular relapse with a detectable BCR-ABL …
Abstract
In the present study, we address the issue of the discontinuation of imatinib mesylate (Gleevec) in chronic myelogenous leukemia with undetectable residual disease for more than 2 years. Twelve patients were included. The median duration of real-time quantitative–polymerase chain reaction (RTQ-PCR) negativity and imatinib therapy were, respectively, 32 months (range, 24-46 months) and 45 months (range, 32-56 months) before imatinib interruption. Six patients displayed a molecular relapse with a detectable BCR-ABL transcript at 1, 1, 2, 3, 4, and 5 months. Imatinib was then reintroduced and led to a novel molecular response in most patients. Six other patients (50%) still have an undetectable level of BCR-ABL transcript after a median follow-up of 18 months (range, 9-24 months). We hypothesize that relapses observed within 6 months reflect the kinetics of undetectable dividing chronic myelogenous leukemia (CML) cells. Those cells may be eradicated or controlled in long-term nonrelapsing patients, as described in our study.
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