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A Pragmatic Approach to Managing Long-Term Adverse Effects in Chronic Myeloid Leukemia Treatment

A Pragmatic Approach to Managing Long-Term Adverse Effects in Chronic Myeloid Leukemia Treatment Purpose of ReviewLong-term outcomes have significantly improved with treatment of chronic myeloid leukemia. With proper treatment, most patients will achieve similar survival rates compared to an age-matched population. Treatment-free remission is not attainable for over half of patients and chronic treatment carries with it unique challenges. We provide a pragmatic approach to the monitoring and management of chronic adverse effects (AEs).Recent FindingsIn the presence of severe or intolerable AEs, switching tyrosine kinase inhibitors (TKIs) is reasonable but is not without risk. Dose reductions can be attempted when response is stable to reduce AE intensity. More frequent molecular monitoring with any change is essential.SummaryTreatment strategies must adapt to the personalized treatment goal of each patient. Long-term survival remains good even when response is less than a complete molecular response. Consider risks of new AEs when changing therapy and evaluate for dose reductions when appropriate. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Hematologic Malignancy Reports Springer Journals

A Pragmatic Approach to Managing Long-Term Adverse Effects in Chronic Myeloid Leukemia Treatment

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Springer Journals
Copyright
Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
ISSN
1558-8211
eISSN
1558-822X
DOI
10.1007/s11899-023-00698-4
Publisher site
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Abstract

Purpose of ReviewLong-term outcomes have significantly improved with treatment of chronic myeloid leukemia. With proper treatment, most patients will achieve similar survival rates compared to an age-matched population. Treatment-free remission is not attainable for over half of patients and chronic treatment carries with it unique challenges. We provide a pragmatic approach to the monitoring and management of chronic adverse effects (AEs).Recent FindingsIn the presence of severe or intolerable AEs, switching tyrosine kinase inhibitors (TKIs) is reasonable but is not without risk. Dose reductions can be attempted when response is stable to reduce AE intensity. More frequent molecular monitoring with any change is essential.SummaryTreatment strategies must adapt to the personalized treatment goal of each patient. Long-term survival remains good even when response is less than a complete molecular response. Consider risks of new AEs when changing therapy and evaluate for dose reductions when appropriate.

Journal

Current Hematologic Malignancy Reports – Springer Journals

Published: Aug 1, 2023

Keywords: Chronic myeloid leukemia; Adverse effects; TKI long-term effects

References

  • European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia
    Hochhaus, A; Baccarani, M; Silver, RT; Schiffer, C; Apperley, JF; Cervantes, F
  • Trends in all-cause mortality among patients with chronic myeloid leukemia: a Surveillance, Epidemiology, and End Results database analysis
    Brunner, AM; Campigotto, F; Sadrzadeh, H; Drapkin, BJ; Chen, Y-B; Neuberg, DS
  • Improved survival in chronic myeloid leukemia since the introduction of imatinib therapy: a single-institution historical experience
    Kantarjian, H; O’Brien, S; Jabbour, E; Garcia-Manero, G; Quintas-Cardama, A; Shan, J
  • Clear improvement in real-world chronic myeloid leukemia survival: a comparison with randomized controlled trials
    Vener, C; Rossi, S; Minicozzi, P; Marcos-Gragera, R; Poirel, HA; Maynadié, M
  • Relative survival in patients with chronic-phase chronic myeloid leukaemia in the tyrosine-kinase inhibitor era: analysis of patient data from six prospective clinical trials
    Sasaki, K; Strom, SS; O’Brien, S; Jabbour, E; Ravandi, F; Konopleva, M
  • Population-based assessment of chronic myeloid leukemia in Sweden: striking increase in survival and prevalence
    Gunnarsson, N; Sandin, F; Höglund, M; Stenke, L; Björkholm, M; Lambe, M
  • Life expectancy of patients with chronic myeloid leukemia approaches the life expectancy of the general population
    Bower, H; Björkholm, M; Dickman, PW; Höglund, M; Lambert, PC; Andersson, TM-L
  • Patients with chronic myelogenous leukemia may not want to discontinue tyrosine kinase inhibitor therapy
    Goldberg, S; Hamarman, S
  • Treatment-free remission in chronic myeloid leukemia: the patient perspective and areas of unmet needs
    Sharf, G; Marin, C; Bradley, JA; Pemberton-Whiteley, Z; Bombaci, F; Christensen, RIO
  • Sustained deep molecular responses in patients switched to nilotinib due to persistent BCR-ABL1 on imatinib: final ENESTcmr randomized trial results
    Hughes, TP; Leber, B; Cervantes, F; Spector, N; Pasquini, R; Clementino, NCD
  • On the road to treatment-free remission in chronic myeloid leukemia: what about ‘the others’?
    Stagno, F; Breccia, M; Di Raimondo, F
  • Chronic Myeloid Leukemia, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology
    Deininger, MW; Shah, NP; Altman, JK; Berman, E; Bhatia, R; Bhatnagar, B
  • Current issues in chronic myeloid leukemia: monitoring, resistance, and functional cure
    Cortes, J; Goldman, JM; Hughes, T
  • Evaluation of Facebook and Twitter monitoring to detect safety signals for medical products: an analysis of recent FDA safety alerts
    Pierce, CE; Bouri, K; Pamer, C; Proestel, S; Rodriguez, H; Van Le, H
  • Monitoring product safety in the postmarketing environment
    Sharrar, RG; Dieck, GS
  • Long-term side effects of tyrosine kinase inhibitors in chronic myeloid leukemia
    Caldemeyer, LE; Dugan, MJ; Edwards, JR; Edwards, JG; Akard, LP
  • European LeukemiaNet recommendations for the management and avoidance of adverse events of treatment in chronic myeloid leukaemia
    Steegmann, JL; Steegmann, JL; Baccarani, M; Baccarani, M; Baccarani, M; Breccia, M
  • Treating the chronic-phase chronic myeloid leukemia patient: which TKI, when to switch and when to stop?
    Patel, AB; Wilds, BW; Deininger, MW
  • A clinician perspective on the treatment of chronic myeloid leukemia in the chronic phase
    García-Gutiérrez, V; Breccia, M; Jabbour, E; Mauro, M; Cortes, JE
  • Dasatinib vs. imatinib in patients with chronic myeloid leukemia in chronic phase (CML-CP) who have not achieved an optimal response to 3 months of imatinib therapy: the DASCERN randomized study
    Cortes, JE; Jiang, Q; Wang, J; Weng, J; Zhu, H; Liu, X
  • Switching to nilotinib versus imatinib dose escalation in patients with chronic myeloid leukaemia in chronic phase with suboptimal response to imatinib (LASOR): a randomised, open-label trial
    Cortes, JE; De Souza, CA; Ayala, M; Lopez, JL; Bullorsky, E; Shah, S
  • Safety and efficacy of elective switch from nilotinib to imatinib in newly diagnosed chronic phase chronic myeloid leukemia
    Ibrahim, A; Moukalled, N; Mahfouz, R; El Cheikh, J; Bazarbachi, A; Abou, DI
  • Precision tyrosine kinase inhibitor dosing in chronic myeloid leukemia?
    Saglio, G; Fava, C; Gale, RP
  • Outcome of very elderly chronic myeloid leukaemia patients treated with imatinib frontline
    Crugnola, M; Castagnetti, F; Breccia, M; Ferrero, D; Trawinska, MM; Abruzzese, E
  • Age influences initial dose and compliance to imatinib in chronic myeloid leukemia elderly patients but concomitant comorbidities appear to influence overall and event-free survival
    Breccia, M; Luciano, L; Latagliata, R; Castagnetti, F; Ferrero, D; Cavazzini, F
  • Imatinib in very elderly patients with chronic myeloid leukemia in chronic phase: a retrospective study
    Latagliata, R; Ferrero, D; Iurlo, A; Cavazzini, F; Castagnetti, F; Abruzzese, E
  • Reduced dose of imatinib for patients with chronic myeloid leukemia and low body surface area
    Park, SJ; Choi, IK; Seo, HY; Sung, HJ; Park, KH; Kim, SJ
  • Imatinib dose reduction in patients with chronic myeloid leukemia in sustained deep molecular response
    Cervantes, F; Correa, J-G; Pérez, I; García-Gutiérrez, V; Redondo, S; Colomer, D
  • Nilotinib versus Imatinib for Newly Diagnosed Chronic Myeloid Leukemia
    Saglio, G; Kim, D-W; Issaragrisil, S; le Coutre, P; Etienne, G; Lobo, C
  • Molecular responses after switching from a standard-dose twice-daily nilotinib regimen to a reduced-dose once-daily schedule in patients with chronic myeloid leukemia: a Real Life Observational Study (NILO-RED)
    Rea, D
  • Frontline dasatinib treatment in a “real-life” cohort of patients older than 65 years with chronic myeloid leukemia
    Latagliata, R; Stagno, F; Annunziata, M; Abruzzese, E; Iurlo, A; Guarini, A
  • Long-term follow-up of lower dose dasatinib (50 mg daily) as frontline therapy in newly diagnosed chronic-phase chronic myeloid leukemia
    Naqvi, K; Jabbour, E; Skinner, J; Anderson, K; Dellasala, S; Yilmaz, M
  • Final 5-year study results of DASISION: the dasatinib versus imatinib study in treatment-naïve chronic myeloid leukemia patients trial
    Cortes, JE; Saglio, G; Kantarjian, HM; Baccarani, M; Mayer, J; Boqué, C
  • Elderly patients with chronic myeloid Leukemia benefit from a dasatinib dose as low as 20 mg
    Itamura, H; Kubota, Y; Shindo, T; Ando, T; Kojima, K; Kimura, S
  • Low-dose dasatinib in older patients with chronic myeloid leukaemia in chronic phase (DAVLEC): a single-arm, multicentre, phase 2 trial
    Murai, K; Ureshino, H; Kumagai, T; Tanaka, H; Nishiwaki, K; Wakita, S
  • Dasatinib dose optimisation based on therapeutic drug monitoring reduces pleural effusion rates in chronic myeloid leukaemia patients
    Rousselot, P; Rousselot, P; Mollica, L; Guilhot, J; Guerci, A; Nicolini, FE
  • Pleural effusion and molecular response in dasatinib-treated chronic myeloid leukemia patients in a real-life Italian multicenter series
    Iurlo, A; Galimberti, S; Abruzzese, E; Annunziata, M; Bonifacio, M; Latagliata, R
  • Bosutinib versus imatinib for newly diagnosed chronic myeloid leukemia: results from the randomized BFORE trial
    Cortes, JE; Gambacorti-Passerini, C; Deininger, MW; Mauro, MJ; Chuah, C; Kim, D-W
  • Dose Optimization in elderly CML patients treated with bosutinib after intolerance or failure of first-line tyrosine kinase inhibitors
    Castagnetti, F; Gugliotta, G; Bocchia, M; Trawinska, MM; Capodanno, I; Bonifacio, M
  • Efficacy and safety following bosutinib dose reduction in patients with Philadelphia chromosome-positive leukemias
    Kota, V; Brümmendorf, TH; Gambacorti-Passerini, C; Lipton, JH; Kim, D-W; An, F
  • Ponatinib dose-ranging study in chronic-phase chronic myeloid leukemia: a randomized, open-label phase 2 clinical trial
    Cortes, J; Apperley, J; Lomaia, E; Moiraghi, B; Undurraga Sutton, M; Pavlovsky, C
  • Patient- versus physician-reporting of symptoms and health status in chronic myeloid leukemia
    Efficace, F; Rosti, G; Aaronson, NK; Cottone, F; Angelucci, E; Molica, S
  • Tyrosine-kinase inhibitors and patient-reported outcomes in chronic myeloid leukemia: a systematic review
    Efficace, F; Cardoni, A; Cottone, F; Vignetti, M; Mandelli, F
  • Health-related quality of life in chronic myeloid leukemia patients receiving long-term therapy with imatinib compared with the general population
    Efficace, F; Baccarani, M; Breccia, M; Alimena, G; Rosti, G; Cottone, F
  • Quality of life outcomes in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors: a controlled comparison
    Phillips, KM; Pinilla-Ibarz, J; Sotomayor, E; Lee, MR; Jim, HSL; Small, BJ
  • Time for patient reported outcomes assessment in routine hematology practice: the case of chronic myeloid leukemia
    Efficace, F; Cottone, F