LATE MOLECULAR RECURRENCES IN PATIENTS WITH CHRONIC MYELOID LEUKEMIA EXPERIENCING TREATMENT FREE REMISSION.
Author(s): ,
Philippe Rousselot
Affiliations:
Hematology,Centre Hospitalier de Versailles, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay,Le Chesnay,France
,
Clémence Loiseau
Affiliations:
Hematology,Centre Hospitalier de Versailles, Université Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay,Le Chesnay,France
,
Marc Delord
Affiliations:
Clinical research center,Centre Hospitalier de Versailles,Le Chesnay,France
,
Jean Michel Cayuela
Affiliations:
4Department of Molecular Biology and EA3518,University hospital Saint-Louis AP-HP and University of Paris,Paris,France
Marc Spentchian
Affiliations:
Department of Molecular Biology,Centre Hospitalier de Versailles,Le Chesnay,France
(Abstract release date: 05/14/20) EHA Library. Rousselot P. 06/12/20; 294665; EP747
Prof. Philippe Rousselot
Prof. Philippe Rousselot
Contributions
Abstract

Abstract: EP747

Type: e-Poster

Background

Treatment free remission (TFR) is an opportunity for patients with chronic myeloid leukemia (CML). In published studies the cumulative incidence curves of molecular recurrence (MRec) arbor a two phases shape with a majority of early MRec and few late events. We included our first patient in a STOP study in 2004. 

Aims

We took advantage of this prolonged follow-up to characterize late MRec (LMRec). 

Methods

Over a 15 years period, 128 patients from our institution were registered in the A-STIM study. MRec was defined by the loss of major molecular response (i.e. BCR-ABL1IS > 0.1%).

Results

Median follow-up in TFR was 6.5 years. Median duration of TKIs before the first TFR attempt and duration of MR4 were 7.1 years and 4 years respectively. The TFR rate was 45.6% (95% confidence interval (CI): 36.1-54.6) after 7 years. LMRec (> 2 years) was observed in 9 out of 65 relapsing patients (14%) after a median of 3.6 years in TFR (range 2.3-6.4 years). Baseline characteristics were not different between patients with early versus late MRec. However, patients with fluctuations of their BCR-ABL1 minimal residual disease (MRD) have an odd ratio of 8 to experience LMRec as compared to patients without (P=0.02).

Conclusion

Among patients experiencing MRec, we observed LMRec in 14% of cases. These events occurred preferentially in patients experiencing fluctuations of their MRD levels. Our findings suggest that a long-term molecular follow-up remain mandatory for CML patients in TFR. The A-STIM study was registered at www.clinicaltrials.gov as #NCT02897245.

Session topic: 08. Chronic myeloid leukemia - Clinical

Keyword(s): Chronic myeloid leukemia

Abstract: EP747

Type: e-Poster

Background

Treatment free remission (TFR) is an opportunity for patients with chronic myeloid leukemia (CML). In published studies the cumulative incidence curves of molecular recurrence (MRec) arbor a two phases shape with a majority of early MRec and few late events. We included our first patient in a STOP study in 2004. 

Aims

We took advantage of this prolonged follow-up to characterize late MRec (LMRec). 

Methods

Over a 15 years period, 128 patients from our institution were registered in the A-STIM study. MRec was defined by the loss of major molecular response (i.e. BCR-ABL1IS > 0.1%).

Results

Median follow-up in TFR was 6.5 years. Median duration of TKIs before the first TFR attempt and duration of MR4 were 7.1 years and 4 years respectively. The TFR rate was 45.6% (95% confidence interval (CI): 36.1-54.6) after 7 years. LMRec (> 2 years) was observed in 9 out of 65 relapsing patients (14%) after a median of 3.6 years in TFR (range 2.3-6.4 years). Baseline characteristics were not different between patients with early versus late MRec. However, patients with fluctuations of their BCR-ABL1 minimal residual disease (MRD) have an odd ratio of 8 to experience LMRec as compared to patients without (P=0.02).

Conclusion

Among patients experiencing MRec, we observed LMRec in 14% of cases. These events occurred preferentially in patients experiencing fluctuations of their MRD levels. Our findings suggest that a long-term molecular follow-up remain mandatory for CML patients in TFR. The A-STIM study was registered at www.clinicaltrials.gov as #NCT02897245.

Session topic: 08. Chronic myeloid leukemia - Clinical

Keyword(s): Chronic myeloid leukemia

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies