Improving the quality of life and achieving Treatment-Free Remission(TFR) is a long-term goal of treatment in CML-CP patients, and deep molecular response (DMR) is necessary to achieve TFR. Cording to the historical literature, it is reported that patients with CML-CP take MMR as the therapeutic target, and the acquisition rate of DMR under long-term TKI treatment is 50%. The 2-year success rate of TFR patients was 50%. Therefore, maybe only 25% of patients with CML can successfully stop the drug for a long time. It cannot meet the withdrawal needs of patients with long-term drug survival. This study is to design a real-world observational registration study for optimal effect. On the premise of taking DMR as the target decision, through initial treatment intervention, improve the DMR rate, which will promote clinical practice, so as to improve the 2-year TFR rate of cml-cp patients. This study is a multicenter, observational, prospective registry to identify the optimal treatment for achieving TFR in CML patients. In this study, the investigators will assess the deep molecular response after 12 months of treatment and the 2-year treatment-free remission rate (TFR 2y) after drug discontinuation. Eligible participants with CML-CP can be enrolled. The observation period of all participants is at least 60 months, of which the first 36 months is the shortest treatment period, and the last 24 months is the TFR observation period after TKIs (Imatinib/Flumatinib/Nilotinb/ Dasatinib) withdrawal. During the treatment phase, participants can receive TKIs ± IFN (or other treatments) as first-line/second-line treatment, and the treatment plan will be adjusted according to the molecular response. Patients should accept TKI treatment for at least 3 years or more, and MR4/MR4.5 should achieve at least 2 years before discontinuation.
Study Type
OBSERVATIONAL
Enrollment
203
Withdrawal TKIs(Tyrosine kinase inhibitors: Imatinib or Flumatinib or Nilotinb or Dasatinib)
Deep molecular response(DMR) rate of 12 months
DMR is defined by IS BCR-ABL/ABL achieve MR4.0(≤0.01%)
Time frame: The 12th month
Treatment-Free Remission(TFR) rate of 2 years
The proportion of drug withdrawal
Time frame: The second year
TFR rate
TFR rate of 6/12months,Median duration of TFR
Time frame: The 6months、12months
DMR rate
DMR rate of 24/36/48/60 months, Median duration of DMR, DMR is defined by IS BCR-ABL/ABL achieve MR4.0
Time frame: The 24/36/48/60 months
DMR persistence rate in 2 years
DMR is defined by IS BCR-ABL/ABL achieve MR4.0
Time frame: 2 years
Disease progression rate , time to progression
Time and proportion from diagnosis to disease progression to AP or BC
Time frame: The whole study, up to 7 years
Loss of Major Molecular Remission(MMR-loss IS BCR-ABL≥0.1%)
Time and proportion from discontinuation to loss of MMR in TFR phase up to 2 years.
Time frame: TFR phase in the study, up to 2 years
Re-Major Molecular Remission
Time and proportion from restarting therapy after MMR-lose to obtain MMR through TFR phase.
Time frame: The TFR phase, up to 2 years
Treatment-related safety
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Time frame: The whole study , up to 7 years
Patient Report Outcome(PRO)
EORTCQLQ-CML-24 survey every 3 months in the whole enrollment period
Time frame: Every 3 months in the whole enrollment period, up to 7 years
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