The Leukemia & Lymphoma Society - Fighting Blood Cancers
6 Replies Latest reply: May 10, 2012 11:52 PM by 0vercast RSS

Stopping TKI Therapy: A doctor's perspective

scuba Registered Users
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Recently published in Oncology Times:

http://journals.lww.com/oncology-times/Fulltext/2012/03100/CML___Stopping_TKI_Therapy_May_Be_Possible_for.4.aspx

 

Jorge Cortes, MD, Professor of Medicine and Chief of the CML Section in the Department of Leukemia of the University of Texas MD Anderson Cancer Center, commented: “Stopping TKI therapy is an attractive concept with important consequences for patients, but if I was a CML patient on a TKI, I would never let the doctor take away the drug. Why take chances? Most of my patients have been on therapy for seven or eight years and are stable. I discuss this three or four times a day in the clinic, but only a handful decide to stop TKIs.”

 

"No one knows why some patients who achieve CMR relapse, he continued. “There must be something else involved— perhaps differences in the immune system or the biology of the disease. Once we learn that, then stopping therapy becomes more attractive.” He added that stopping TKI therapy “should be done only with close monitoring. If the patient relapses, we want to know quickly.”

 

JORGE CORTES, MD: St...

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  • Re: Stopping TKI Therapy: A doctor's perspective
    valiantchong Registered Users
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    So scub,

     

    You still wana stop if you achieve CMR ?? base on the dr.. it is not recommended...

  • Re: Stopping TKI Therapy: A doctor's perspective
    cousineg Registered Users
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    Other articles about  STIM - STop  IMatinib

  • Re: Stopping TKI Therapy: A doctor's perspective
    pamsouth Registered Users
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    A thought that keeps popping up in my head.  I understand that 90 % of people with CML have the ph+ which means that not everyone that has CML has the BCR/ABL.  Therefore if the TKI’s only kill the PH+ then you still have CML.  Therefore .... ???

     

    I also understand the FISH and PCR test only check for the bcr/abl.  I know I’m at the pointing of  sounding redundant. I’m trying to look for the right language/words.  So if you were to kill all the BCR/ABLE but still have the ancient CML stem cell that produced the bcr/able, then until you find a drug that kills the CML Stem Cell at the top level where the bone marrow produces this defective stem cells, I’m still rambling here.  Then this ancient stem cell creates a protective environment. Well then in conclusion; there is forever a chance of PH+. 

     

    Moving on to next question/thoughts.  If you were to kill all the PH+ except you still have  the Ancient CML stem cells, but no PH+ , what kind of problems does CML stem cell without the PH+ cause, (that is if you were cured of the PH+.)  Perhaps a better way to ask the question,  for people who have CML but not PH+ what are there health issues?

     

    Sorry I am being redundant, but just trying to get my thoughts across. 

    PamSouth

  • Re: Stopping TKI Therapy: A doctor's perspective
    0vercast Registered Users
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    This sounds really promising.  I can't wait to see how this plays out over the next few years.  I'm not even CCyR yet, so it'll be a while before I'm eligible for something like this.  A person might actually be cured of CML, and this is the only way to really find out, am I right?  It appears so far that absolutely everybody responds to the re-introduction of their TKI after relapse.

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