Stopping Study in Chronic Myeloid Leukemia – Defining a New Paradigm for Ontario CML1 Â
Standing
Undergraduate
Type of Proposal
Oral Research Presentation
Challenges Theme
Open Challenge
Faculty Sponsor
Dr. Caroline Hamm
Proposal
Objectives: We aim to test a new paradigm for safely stopping tyrosine kinase inhibitor (TKI) treatment in chronic myeloid leukemia (CML) patients by monitoring molecular response every 6 weeks for 6 months instead of the recommended 4-week intervals. Methods: A prospective pilot cohort study was conducted to assess the outcome of cessation of TKI treatment in chronic-phase CML patients. Patients' polymerase chain reaction (PCR) for BCR-ABL was tested every 6 weeks for 36 weeks to ensure ongoing major molecular response (MMR). Withdrawal syndrome, psychological effects, and quality of life as per the EORTC Global Quality of Life (QoL) scoring system were assessed during each visit every 6 weeks for 36 weeks. Results: 18 consenting patients were enrolled, 3 were eliminated from data analysis as additional time is required to assess their molecular responses after stopping. 12 of the 15 enrolled participants were able to successfully stop TKI therapy and remain in remission, yielding an 80% success rate in safely stopping TKI therapy. 3 patients had relapsed and successfully regained MR with resumption of TKI therapy. Conclusion: According to literature, the successful stopping rate in CML is 50%. The 80% success rate may be attributed to the longer duration of treatment and being a first stopping study opportunity for patients in Windsor. Limitations of this study include a small sample size. We hope to expand this study in Ontario and test this real-world paradigm of testing CML patients who stop their TKI every 6 weeks, in larger populations in the future.
Grand Challenges
Viable, Healthy and Safe Communities
Stopping Study in Chronic Myeloid Leukemia – Defining a New Paradigm for Ontario CML1 Â
Objectives: We aim to test a new paradigm for safely stopping tyrosine kinase inhibitor (TKI) treatment in chronic myeloid leukemia (CML) patients by monitoring molecular response every 6 weeks for 6 months instead of the recommended 4-week intervals. Methods: A prospective pilot cohort study was conducted to assess the outcome of cessation of TKI treatment in chronic-phase CML patients. Patients' polymerase chain reaction (PCR) for BCR-ABL was tested every 6 weeks for 36 weeks to ensure ongoing major molecular response (MMR). Withdrawal syndrome, psychological effects, and quality of life as per the EORTC Global Quality of Life (QoL) scoring system were assessed during each visit every 6 weeks for 36 weeks. Results: 18 consenting patients were enrolled, 3 were eliminated from data analysis as additional time is required to assess their molecular responses after stopping. 12 of the 15 enrolled participants were able to successfully stop TKI therapy and remain in remission, yielding an 80% success rate in safely stopping TKI therapy. 3 patients had relapsed and successfully regained MR with resumption of TKI therapy. Conclusion: According to literature, the successful stopping rate in CML is 50%. The 80% success rate may be attributed to the longer duration of treatment and being a first stopping study opportunity for patients in Windsor. Limitations of this study include a small sample size. We hope to expand this study in Ontario and test this real-world paradigm of testing CML patients who stop their TKI every 6 weeks, in larger populations in the future.