Safety and efficacy of imatinib cessation for CML patients with stable undetectable minimal residual disease: results from the TWISTER study
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...These results are in line with the detection of the BCR-ABL signal using PCR on DNA from patients with CMR.4 In confirmation, we have observed repeated and significant positive values of BCR-ABL transcript levels in patients who discontinued imatinib....
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...These results were confirmed in more patients, with longer follow-up,(3) as well as in three independent studies.(4-6)...
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...The safety of tyrosine kinase inhibitor (TKI) discontinuation is now supported by the results and the follow-up of at least four studies, including the STIM study, and no event of progression was described.(1-6) We report here the first case, to our knowledge, of progression to blast crisis after a trial of imatinib cessation....
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...We also investigated if patients with unstable cCMR before study entry were at higher risk of losing MMR as compared with patients with stable cCMR. RFS curves were not statistically different (Fig 3A)....
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...Conclusion Loss of MMR is a practical and safe criterion for restarting therapy in patients with CML with prolonged CMR....
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