{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:00:41Z","timestamp":1788778841886,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T00:00:00Z","timestamp":1694390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009812","name":"Princess Margaret Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009812","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Multiple studies have reported a significant treatment\u2010free remission (TFR) rate of 50%\u201360% in patients with chronic myeloid leukaemia (CML) who discontinue tyrosine kinase inhibitor (TKI) therapy. However, the remaining half of these patients still require re\u2010initiation of TKI therapy for leukaemia control. It remains unclear if TKI drugs should be switched for re\u2010therapy in patients who failed the first TFR (TFR1) attempt. Our study attempted to determine whether dasatinib therapy after TFR1 failure post\u2010imatinib discontinuation could improve the likelihood of TFR2. Of 59 patients who lost molecular response after imatinib discontinuation for TFR1, 55 patients (93.2%) were treated with dasatinib, of whom 49 (89.1%) regained MR4.5 or deeper response, with a median time of 1.85\u2009months to achieve MR4.5. Dasatinib was discontinued in 35 patients for TFR2 attempt, of whom 26 patients (74.28%) lost MMR and 6 (17.14%) MR4. Risk factor analysis for the TFR2 after dasatinib discontinuation suggested three significant factors: (1) doubling time of\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    transcript following TFR1 attempt, (2) rapid regaining of molecular response following dasatinib therapy and (3) undetectable\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    transcript prior to TFR2 attempt. The present study showed that dasatinib does not increase the TFR2 rate in general, but a selected group of patients could benefit from this approach.\n                  <\/jats:p>","DOI":"10.1111\/bjh.19058","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:06:18Z","timestamp":1694477178000},"page":"781-791","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Final report of\n                    <scp>TKI<\/scp>\n                    discontinuation trial with dasatinib for the second attempt of treatment\u2010free remission after failing the first attempt with imatinib: Treatment\u2010free Remission Accomplished by Dasatinib (\n                    <scp>TRAD<\/scp>\n                    ) study"],"prefix":"10.1111","volume":"203","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1893-6096","authenticated-orcid":false,"given":"Maria Agustina","family":"Perusini","sequence":"first","affiliation":[{"name":"Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Novitzky\u2010Basso","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network  Toronto Ontario Canada"},{"name":"Department of Hematology, Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4613-3680","authenticated-orcid":false,"given":"Eshetu G.","family":"Atenafu","sequence":"additional","affiliation":[{"name":"Biostatistic Department, Princess Margaret Cancer Centre University Health Network  Toronto Ontario 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and Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lambert","family":"Busque","sequence":"additional","affiliation":[{"name":"Hematopoiesis and Aging Research Unit University of Montreal, H\u00f4pital Maisonneuve\u2010Rosemont  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Delage","sequence":"additional","affiliation":[{"name":"Centre Universitaire d'H\u00e9matologie et d'Oncologie de Qu\u00e9bec, CHU de Qu\u00e9bec, H\u00f4pital de l'Enfant\u2010J\u00e9sus  Quebec City Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anargyros","family":"Xenocostas","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine London Health Sciences Centre, University of Western Ontario  London Ontario 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