What is it about?

Most people with chronic myeloid leukaemia (CML) need daily treatment for many years or life. Only some achieve a response deep enough to try stopping, and we cannot reliably predict whose CML will return. We investigated whether the blood-cell types carrying tiny traces of CML could provide a clue. This revealed groups with high, intermediate or low relapse risk.

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Why is it important?

Tyrosine kinase inhibitors can control CML for decades, but lifelong treatment can bring persistent side effects and cumulative toxicities. For eligible patients, remaining well without medication, known as treatment-free remission, offers the possibility of a functional cure. Predicting the outcome beforehand could identify who may stop with a high chance of success and who may benefit from longer treatment or different strategies.

Perspectives

For me, this work represents the next chapter in chronic myeloid leukaemia. Targeted therapies transformed a once-fatal disease into one that can often be controlled for decades. However, for most patients, that control still depends on daily treatment, sometimes accompanied by persistent side effects and long-term toxicities. My vision is to move beyond lifelong disease control towards a personalised pathway to cure. When patients consider stopping treatment, they must balance the hope of a life without medication against the fear of relapse. I want to replace some of that uncertainty with evidence: to identify who is likely to remain treatment-free, understand why others relapse and develop new strategies that bring treatment-free remission within reach for more people. This study was an important first step. It has helped shape our National CML Treatment-Free Remission Registry, where we are now working to transform a promising research finding into better, more informed decisions for patients and clinicians.

Dr Ilaria Stefania Pagani
SAHMRI

Read the Original

This page is a summary of: Lineage-specific detection of residual disease predicts relapse in patients with chronic myeloid leukemia stopping therapy, Blood, December 2023, American Society of Hematology,
DOI: 10.1182/blood.2023021119.
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