{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:18:44Z","timestamp":1779322724365,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T00:00:00Z","timestamp":1613433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intermittent treatment with TKIs is an option for the great majority (70%\u201380%) of CML patients who do not achieve a stable deep molecular response and are not eligible for treatment discontinuation. For these patients, the only alternative is to assume TKI continuously, lifelong.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Italian phase III multicentric randomized OPTkIMA study started in 2015, with the aim to evaluate if a progressive de\u2010escalation of TKIs (imatinib, nilotinib, and dasatinib) is able to maintain the molecular response (MR<jats:sup>3.0<\/jats:sup>) and to improve Health Related Quality of Life (HRQoL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Up to December 2018, 166\/185 (90%) elderly CML patients in stable MR<jats:sup>3.0<\/jats:sup>\/MR<jats:sup>4.0<\/jats:sup> completed the first year of any TKI intermittent schedule 1\u00a0month ON and 1\u00a0month OFF. The first year probability of maintaining the MR<jats:sup>3.0<\/jats:sup> was 81% and 23.5% of the patients who lost the molecular response regained the MR<jats:sup>3.0<\/jats:sup> after resuming TKI continuously. Patients\u2019 HRQoL at baseline was better than that of matched peers from healthy population. Women was the only factor independently associated with worse baseline HRQoL (<jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.0001). Overall, global HRQoL worsened at 6 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) but returned to the baseline value at 12\u00a0months and it was statistically significantly worse in women (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>De\u2010escalation of any TKI by 1\u00a0month ON\/OFF schedule maintains the MR<jats:sup>3.0<\/jats:sup>\/MR<jats:sup>4.0<\/jats:sup> in 81% of the patients during the first 12\u201324\u00a0months. No patients progressed to accelerated\/blastic phase, all the patients (23.5%) losing MR<jats:sup>3.0<\/jats:sup> regained the MR<jats:sup>3.0<\/jats:sup> and none suffered from TKI withdrawn syndrome. The study firstly report on HRQoL in elderly CML patients moving from a continuous daily therapy to a de\u2010escalated intermittent treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.3778","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T06:06:41Z","timestamp":1613801201000},"page":"1726-1737","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Molecular response and quality of life in chronic myeloid leukemia patients treated with intermittent TKIs: First interim analysis of OPTkIMA study"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0907-130X","authenticated-orcid":false,"given":"Michele","family":"Malagola","sequence":"first","affiliation":[{"name":"Unit of Blood Disease and Stem Cell Transplantation Department of Clinical and Experimental Sciences University of Brescia ASST\u2010Spedali Civili Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4401-0812","authenticated-orcid":false,"given":"Alessandra","family":"Iurlo","sequence":"additional","affiliation":[{"name":"Hematology Division Foundation IRCCS Ca Granda Ospedale Maggiore Policlinico Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5228-6491","authenticated-orcid":false,"given":"Elisabetta","family":"Abruzzese","sequence":"additional","affiliation":[{"name":"Division of Hematology S. 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