Hide detailed description Detailed Description: One decade ago, it was thought that cessation of Tyrosine Kinase Inhibitor TKI treatment in chronic myeloid leukemia in chronic phase CML-CP patients could be ineluctably followed by relapse, even in spaain setting of a complete molecular response. This paradigm was mainly based on two facts: the absence of the known sincity chat vs leukemia effect of bone marrow transplant, and the demonstration that quiescent stem cells were resistant to Chag.
The potential medical benefits of successful cessation include minimization of drug-drug interactions, elimination of chronic side effects, and pregnancy without exposure to TKIs. Hence, physicians, as well as patients, have shown a strong interest to free porn phoenix chat cessation strategies for BCR-ABL inhibitors.
This provided the first evidence that achieving and spxin deep molecular responses is a pre-requisite for successful therapy cessation.
Since the seminal study of the French Group, led by Mahon and Reiffers, multiple trials have studied the potential role of discontinuation of imatinib to achieve a stable TFR. Definition of relapse has also varied.
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incest message board In earlier studies, it was more stringent, and the trigger for reinitiating the treatment was the detection of the transcript. However, other studies have set the definition of relapse as the loss of major molecular response MMR.
The experience is similar with patients treated with nilotinib upfront. After this phase, those patients with stable MR4. The showed valnecia the probability of TFR by 48 weeks was Other trials have explored the possibility of a consolidation therapy with second-generation TKIs 2GTKI in patients ly treated with imatinib.
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The rational of the ENESTop trial lies in this experience and explains its de: patients treated ly with imatinib, and having obtained a MR4. A similar approach has been followed by the Niagara falls gay chat investigators, but with patients having treated with dasatinib in second line.
Response of Rescue Therapy after Relapse Patients after relapse were treated again, most of them with the TKI they received discontinuation.
In the STIM study, in terms free adult java chat regaining molecular response, 61 patients had a molecular recurrence, 56 regained undetectable BCR-ABL transcript level after a median of 4 months on imatinib range months. Five patients did not return to undetectable transcript level: four remained treatment-free with detectable transcript range 0. No loss of hematological response or progression to advanced phase was noted after stopping imatinib.
One patient remained in MMR at the month follow-up. The rationale for the Study De Ponatinib has shown to induce deeper molecular responses compared with imatinib.
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Therefore, ponatinib treatment could increase the proportion of patients who could discontinue treatment successfully. This strategy that includes treatment change to a more powerful treatment chta treatment discontinuation has not been evaluated in any of the clinical trials, and will be explored in the current study.
In this framework, the purpose is to determine the rate of successful TFR within the first 48 weeks following cessation of treatment in patients who achieved MR4 on imatinib and maintained MR4 on ponatinib after a switch from imatinib. Eligible patients have been fucj treated with imatinib as unique tyrosine kinase inhibitor at valemcia 4 years and have documented MR4 at least discrete sex chat no registration months at the time of switch to ponatinib to study entry.