{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T13:17:29Z","timestamp":1695475049424},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,1,28]],"date-time":"2014-01-28T00:00:00Z","timestamp":1390867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Previous studies indicate that 40\u201350% of patients with chronic myeloid leukemia in prolonged complete molecular remission may discontinue imatinib therapy without imminent relapse. The combination of pegylated interferon\u2010alpha (Peg\u2010<jats:styled-content style=\"fixed-case\">IFN<\/jats:styled-content>\u2010\u03b12b) and imatinib may increase the rate of successful discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this pilot study, we prospectively stopped imatinib from patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) who had achieved major molecular response (<jats:styled-content style=\"fixed-case\">MMR<\/jats:styled-content>) after \u226512\u00a0months of treatment with either imatinib or imatinib+Peg\u2010<jats:styled-content style=\"fixed-case\">IFN<\/jats:styled-content>\u2010\u03b12b. Molecular monitoring was carried out monthly for <jats:styled-content style=\"fixed-case\">BCR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ABL<\/jats:styled-content>1. In addition, analyses of lymphocyte immunophenotype, function, and plasma cytokines were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the monotherapy group, 5\/6 patients lost <jats:styled-content style=\"fixed-case\">MMR<\/jats:styled-content> within 4\u00a0months. One patient remains to date in <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content><jats:sup>4.0<\/jats:sup> 61\u00a0months after discontinuation. In the combination therapy group, 2\/6 patients relapsed within 4\u00a0months while still receiving <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>eg\u2010<jats:styled-content style=\"fixed-case\">IFN<\/jats:styled-content>\u2010\u03b12b. Four of six patients were able to discontinue both treatments, but three of these patients relapsed after 3\u00a0months. One patient is still in sustained <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content><jats:sup>4.0<\/jats:sup> at 58\u00a0months off all treatment. All relapsed patients re\u2010responded to imatinib. The two successfully discontinued patients had either an increased number of <jats:styled-content style=\"fixed-case\">NK<\/jats:styled-content>\u2010cells or functionally active <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>\u2010cells.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A higher frequency of relapsed patients in our study in comparison with other studies may be due to the shorter duration of imatinib treatment prior to discontinuation. However, in selected patients with an active immune system, even a short duration of <jats:styled-content style=\"fixed-case\">TKI<\/jats:styled-content> therapy (&lt;2\u00a0yr) may allow for therapy discontinuation but this needs to be confirmed in larger prospective studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.12258","type":"journal-article","created":{"date-parts":[[2013,12,24]],"date-time":"2013-12-24T08:26:47Z","timestamp":1387873607000},"page":"413-420","source":"Crossref","is-referenced-by-count":11,"title":["Imatinib and pegylated <scp>IFN<\/scp>\u2010<i>\u03b1<\/i>2b discontinuation in first\u2010line chronic myeloid leukemia patients following a major molecular response"],"prefix":"10.1111","volume":"92","author":[{"given":"Perttu","family":"Koskenvesa","sequence":"first","affiliation":[{"name":"Hematology Research Unit Helsinki Department of Medicine Helsinki University Central Hospital and University of Helsinki Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Kreutzman","sequence":"additional","affiliation":[{"name":"Hematology Research Unit Helsinki Department of Medicine Helsinki University Central Hospital and University of Helsinki Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Rohon","sequence":"additional","affiliation":[{"name":"Hematology Research Unit Helsinki Department of Medicine Helsinki University Central Hospital and University of Helsinki Helsinki Finland"},{"name":"Department of Hemato\u2010Oncology Faculty Hospital Olomouc and Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Pihlman","sequence":"additional","affiliation":[{"name":"Hematology Research Unit Helsinki Department of Medicine Helsinki University Central Hospital and University of Helsinki Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmi","family":"Vakkila","sequence":"additional","affiliation":[{"name":"Hematology Research Unit Helsinki Department of Medicine Helsinki University Central Hospital and University of Helsinki Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anu","family":"R\u00e4s\u00e4nen","sequence":"additional","affiliation":[{"name":"Kymenlaakso Central Hospital Kotka Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirja","family":"Vapaatalo","sequence":"additional","affiliation":[{"name":"Department of Medicine Helsinki University central Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kari","family":"Remes","sequence":"additional","affiliation":[{"name":"Turku University Central Hospital Turku 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