• Noortje Thielen, Bronno van der Holt, Jan J Cornelissen, Gregor E G Verhoef, Titia Gussinklo, Bart J Biemond, Simon M G Daenen, Wendy Deenik, Rien van Marwijk Kooy, Eefke Petersen, Willem M Smit, Peter J M Valk, Gert J Ossenkoppele, and Jeroen J W M Janssen.
• Department of Haematology, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: n.thielen@vumc.nl.
• Eur. J. Cancer. 2013 Oct 1; 49 (15): 3242-6.

BackgroundTyrosine kinase inhibitors treatment in responding chronic myeloid leukaemia (CML) patients is generally continued indefinitely. In this randomised phase II trial, we investigated whether CML patients in molecular response(4.5) (MR(4.5), quantitative reverse-transcription polymerase chain reaction (RQ-PCR)) after previous combination therapy with imatinib and cytarabine may discontinue imatinib treatment safely.Patients And MethodsThirty-three patients from the HOVON 51 study with an MR(4.5) for at least 2 years who were still on imatinib treatment were randomised between continuation of imatinib (arm A, n=18) or discontinuation of imatinib (arm B, n=15).ResultsAfter a median follow up of 36 months since randomisation, 3 patients (17%) in arm A and 10 patients (67%) in arm B had a molecular relapse. All 3 relapsing patients in arm A had also stopped imatinib after randomisation. All but one relapsing patient relapsed within 7 months after discontinuation of imatinib. The molecular relapse rate at 12 and 24 months after randomisation was 0% and 6% (arm A) and 53% and 67% (arm B) respectively. As-treated analysis revealed 56% and 61% relapses at 1 and 2 years since cessation in patients who discontinued imatinib, in contrast to 0% of patients who continued imatinib. All evaluable patients remained sensitive to imatinib after reinitiation and regained a molecular response.ConclusionOur data suggest that discontinuation of imatinib is safe in patients with durable MR(4.5).Copyright © 2013 Elsevier Ltd. All rights reserved.

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