Objective To observe and analyze the clinical manifestations and outcomes of chronic myelogenous leukemia(CML)patients treated with tyrosine kinase inhibitor(TKI)after drug discontinuation criteria.Methods The clinical data of 44 eligible CML patients who discontinued TKI from January 1,2015 to December 31.2017 in the Department of Hematol-ogy of Guangdong Huazhong University of Science and Technology Union Shenzhen Hospital and were followed up for a long time were retrospectively analyzed,and the situation of treaty-free remission after discontinuation of TKI and its influencing factors were observed.Results The median time of 44 patients receiving TKI was 59.5(37,102)months.Among them,40 patients had a history of reduction.All patients obtained the efficacy of major molecular remission(MMR)or above before discontinuation.At a median follow-up of 15(5,30)months,34 patients(77.27％)achieved long-term treatment free remis-sion(TFR).Ten patients(22.73％)lost MMR.In 10 patients who lost MMR,drug therapy was restarted,and 8 of them achieved efficacy above MMR after restart.Kaplan-Meier method was used to analyze the clinical characteristics of 44 pa-tients before drug discontinuation,34 patients finally obtained TFR.and 10 patients relapsed after drug discontinuation,with a recurrence rate of 29.41％.Univariate analysis showed that there were no significant differences in gender,age,MMR ac-quisition time and Sokal score between the two groups(P＞0.05).The difference was statistically significant in the recur-rence rate between patients with MMR maintenance time＜24 months before drug discontinuation and patients with MMR maintenance time ≥ 24 months before drug discontinuation(P＜0.05).Multivariate analysis by logistic regression model showed that MMR maintenance time＜24 months(β=0.519,OR=2.951,95％CI=1.187-7.526)was an independent risk factor for molecular relapse in CML patients(P＜0.05).Conclusion TKI can be stopped only after CML patients meet the criteria for drug discontinuation,and the longer MMR maintenance time before drug discontinuation,the lower the recur-rence rate of patients after drug discontinuation.
维普
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