{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:30:37Z","timestamp":1788395437839,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020853","name":"Department of Medicine and Surgery","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020853","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Disease progression to accelerated\/blast phase (AP\/BP) in patients with chronic phase chronic myeloid leukemia (CP\u2010CML) after treatment discontinuation (TD) has never been systematically reported in clinical trials. However, recent reports of several such cases has raised concern. To estimate the risk of AP\/BP among TD\u2010eligible patients, we conducted TFR\u2010PRO, a cohort retro\u2010prospective study: 870 CP\u2010CML patients eligible for TD formed a discontinuation cohort (505 patients) and a reference one (365 patients). The primary objective was the time adjusted rate (TAR) of progression in relation to TD. Secondary endpoints included the TAR of molecular relapse, that is, loss of major molecular response (MMR). With a median follow up of 5.5\u2009years and 5188.2 person\u2010years available, no events occurred in the TD cohort. One event of progression was registered 55\u2009months after the end of TD, when the patient was contributing to the reference cohort. The TAR of progression was 0.019\/100 person\u2010years (95% CI [0.003\u20130.138]) in the overall group; 0.0 (95% CI [0\u20130.163]) in the discontinuation cohort; and 0.030 (95% CI [0.004\u20130.215]) in the reference cohort. These differences are not statistically significant. Molecular relapses occurred in 172\/505 (34.1%) patients after TD, and in 64\/365 (17.5%) patients in the reference cohort, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001. Similar rates were observed in TD patients in first, second or third line of treatment. CML progression in patients eligible for TD is rare and not related to TD. Fears about the risk of disease progression among patients attempting TD should be dissipated.<\/jats:p>","DOI":"10.1002\/ajh.27073","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T15:59:25Z","timestamp":1693411165000},"page":"1762-1771","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Risk of progression in chronic <scp>phase\u2010chronic<\/scp> myeloid leukemia patients eligible for tyrosine kinase inhibitor discontinuation: Final analysis of the <scp>TFR\u2010PRO<\/scp> study"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8612-2994","authenticated-orcid":false,"given":"Giovanni Paolo Maria","family":"Zambrotta","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery University of Milano\u2010Bicocca  Monza Italy"},{"name":"Hematology Department Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3779-1996","authenticated-orcid":false,"given":"Franck E.","family":"Nicolini","sequence":"additional","affiliation":[{"name":"H\u00e9matologie clinique &amp; INSEM U1052 Centre L\u00e9on B\u00e9rard  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarit","family":"Assouline","sequence":"additional","affiliation":[{"name":"Department of Medicine and Oncology, Jewish General Hospital McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lambert","family":"Busque","sequence":"additional","affiliation":[{"name":"Hematology Division, Research Center, H\u00f4pital Maisonneuve\u2010Rosemont Universit\u00e9 de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester","family":"Pungolino","sequence":"additional","affiliation":[{"name":"Division of Hematology ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Abruzzese","sequence":"additional","affiliation":[{"name":"Hematology, S. 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