Michel, Christian, Burchert, Andreas, Hochhaus, Andreas, Saussele, Susanne, Neubauer, Andreas, Lauseker, Michael, Krause, Stefan W., Kolb, Hans-Jochem, Hossfeld, Dieter Kurt, Nerl, Christoph, Baerlocher, Gabriela M., Heim, Dominik, Bruemmendorf, Tim H., Fabarius, Alice, Haferlach, Claudia, Schlegelberger, Brigitte, Balleisen, Leopold, Goebeler, Maria-Elisabeth, Haenel, Mathias, Ho, Anthony, Dengler, Jolanta, Falge, Christiane, Moehle, Robert, Kremers, Stephan, Kneba, Michael, Stegelmann, Frank, Koehne, Claus-Henning, Lindemann, Hans-Walter, Waller, Cornelius F., Spiekermann, Karsten, Berdel, Wolfgang E., Mueller, Lothar, Edinger, Matthias, Mayer, Jiri, Beelen, Dietrich W., Bentz, Martin, Link, Hartmut, Hertenstein, Bernd, Fuchs, Roland, Wernli, Martin, Schlegel, Frank, Schlag, Rudolf, de Wit, Maike, Truemper, Lorenz, Hebart, Holger, Hahn, Markus, Thomalla, Joerg, Scheid, Christof, Schafhausen, Philippe, Verbeek, Walter, Eckart, Michael J., Gassmann, Winfried, Schenk, Michael, Brossart, Peter, Wuendisch, Thomas, Geer, Thomas, Bildat, Stephan, Schaefer, Erhardt, Hasford, Joerg, Hehlmann, Ruediger and Pfirrmann, Markus (2019). Imatinib dose reduction in major molecular response of chronic myeloid leukemia: results from the German Chronic Myeloid Leukemia-Study IV. Haematologica, 104 (5). S. 955 - 963. PAVIA: FERRATA STORTI FOUNDATION. ISSN 0390-6078

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Abstract

Standard first-line therapy of chronic myeloid leukemia is treatment with imatinib. In the randomized German Chronic Myeloid Leukemia-Study IV, more potent BCR-ABL inhibition with 800 mg ('high-dose') imatinib accelerated achievement of a deep molecular remission. However, whether and when a de-escalation of the dose intensity under high-dose imatinib can be safely performed without increasing the risk of losing deep molecular response is unknown. To gain insights into this clinically relevant question, we analyzed the outcome of imatinib dose reductions from 800 mg to 400 mg daily in the Chronic Myeloid Leukemia-Study IV. Of the 422 patients that were randomized to the 800 mg arm, 68 reduced imatinib to 400 mg after they had achieved at least a stable major molecular response. Of these 68 patients, 61 (90%) maintained major molecular remission on imatinib at 400 mg. Five of the seven patients who lost major molecular remission on the imatinib standard dose regained major molecular remission while still on 400 mg imatinib. Only two of 68 patients had to switch to more potent kinase inhibition to regain major molecular remission. Importantly, the lengths of the intervals between imatinib high-dose treatment before and after achieving major molecular remission were associated with the probabilities of maintaining major molecular remission with the standard dose of imatinib. Taken together, the data support the view that a deep molecular remission achieved with high-dose imatinib can be safely maintained with standard dose in most patients.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Michel, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Burchert, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hochhaus, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Saussele, SusanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neubauer, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lauseker, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krause, Stefan W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kolb, Hans-JochemUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hossfeld, Dieter KurtUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nerl, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baerlocher, Gabriela M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heim, DominikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bruemmendorf, Tim H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fabarius, AliceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haferlach, ClaudiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlegelberger, BrigitteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Balleisen, LeopoldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goebeler, Maria-ElisabethUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haenel, MathiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ho, AnthonyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dengler, JolantaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Falge, ChristianeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moehle, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kremers, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kneba, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stegelmann, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koehne, Claus-HenningUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lindemann, Hans-WalterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Waller, Cornelius F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spiekermann, KarstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berdel, Wolfgang E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, LotharUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Edinger, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mayer, JiriUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Beelen, Dietrich W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bentz, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Link, HartmutUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hertenstein, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fuchs, RolandUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wernli, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlegel, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlag, RudolfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Wit, MaikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Truemper, LorenzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hebart, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hahn, MarkusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thomalla, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scheid, ChristofUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schafhausen, PhilippeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Verbeek, WalterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eckart, Michael J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gassmann, WinfriedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schenk, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brossart, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wuendisch, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Geer, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bildat, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaefer, ErhardtUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hasford, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hehlmann, RuedigerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfirrmann, MarkusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-150230
DOI: 10.3324/haematol.2018.206797
Journal or Publication Title: Haematologica
Volume: 104
Number: 5
Page Range: S. 955 - 963
Date: 2019
Publisher: FERRATA STORTI FOUNDATION
Place of Publication: PAVIA
ISSN: 0390-6078
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CHRONIC MYELOGENOUS LEUKEMIA; TREATMENT-FREE REMISSION; QUALITY-OF-LIFE; CHRONIC-PHASE; RANDOMIZED CML; SURVIVAL; DASATINIB; NILOTINIB; THERAPY; 5-YEARMultiple languages
HematologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/15023

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