Why are not all eligible chronic myeloid leukemia patients willing to attempt tyrosine kinase inhibitor discontinuation? A Czech nationwide analysis related to the TKI stopping trial HALF

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Authors

ŽÁČKOVÁ Daniela SEMERÁD Lukáš FABER Edgar KLAMOVÁ Hana STEJSKAL Lukáš BĚLOHLÁVKOVÁ Petra KARAS Michal CMUNT Eduard ČERNÁ Olga PROCHÁZKOVÁ Jiřina ČIČÁTKOVÁ Petra KVETKOVÁ Anežka HORŇÁK Tomáš SKOUMALOVÁ Ivana SRBOVÁ Dana ŠÁLEK Cyril BUFFA David VOGLOVÁ Jaroslava JURČEK Tomáš FOLTA Adam JEŽÍŠKOVÁ Ivana ŽIŽKOVÁ Hana MACHOVÁ POLÁKOVÁ Kateřina PAPAJÍK Tomáš ŽÁK Pavel JINDRA Pavel SVOBODNÍK Adam ŠTĚPÁNOVÁ Radka MAYER Jiří

Year of publication 2024
Type Article in Periodical
Magazine / Source Leukemia
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.nature.com/articles/s41375-024-02215-9
Doi http://dx.doi.org/10.1038/s41375-024-02215-9
Keywords chronic myeloid leukemia; tyrosine kinase inhibitor
Attached files
Description Tyrosine kinase inhibitor (TKI) therapy discontinuation with the aim of achieving treatment-free remission (TFR) is becoming more frequent, as an increasing number of chronic myeloid leukemia (CML) patients are achieving stable deep molecular response (DMR; i.e. BCR::ABL1 transcript level ?0.01% on the International Scale); however, many challenges remain unresolved. Among others, a nonnegligible proportion of patients reported fear, anxiety, or depression both during TFR and when they had to reinitiate TKI therapy. Similar negative feelings are frequently mentioned in the context of the decision to not stop TKI treatment; furthermore, a considerable proportion of patients (17–50%) have been reported to be unwilling to attempt TFR. However, little is known about how many truly eligible patients are unwilling to attempt TFR, the reasons for their decision and what factors are associated with their unwillingness to discontinue long-term therapy since the reports mentioned above have substantial limitations. The surveys were often conducted in a limited number of centres, focused on patients who are able to use internet tools, focused on more educated patients who are connected to patient supportive organisations, and usually not specifically focused on patients who fulfilled the criteria for TKI discontinuation.
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