Early predictors of MR4.5 attainment and eligibility for TKI discontinuation in CML treated with second-generation TKIs - PubMed
3 hours ago
- #molecular response
- #TKI discontinuation
- #CML
- Second-generation TKIs (2G-TKIs) like nilotinib and dasatinib induce faster and deeper molecular responses than imatinib in CML patients.
- Predictors of attaining MR4.5 (BCR::ABL1 IS ≤ 0.0032%) during 2G-TKI therapy were undefined; this study analyzed 431 patients from the JALSG CML212 trial.
- Key predictors assessed within 6 months included ELTS score, BCR::ABL1 IS levels at baseline, 3 months, and 6 months, and halving times HT(0-3) and HT(3-6).
- TKI discontinuation eligibility (TDE) required ≥3 years of TKI therapy with ≥2 consecutive years of sustained MR4.5.
- Cumulative incidence of MR4.5 was 46.6%, with 36.3% of those achieving MR4.5 meeting TDE criteria.
- HT(0-3) and 6-month IS were independent predictors of MR4.5 attainment, while only 6-month IS predicted TDE.
- Molecular response at 6 months after TKI initiation is clinically valuable for early stratification of MR4.5 attainment and TDE in 2G-TKI therapy.