Characteristics of Patients With CML Willing to Attempt Treatment-Free Remission

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Only 34% of patients with chronic myeloid leukemia (CML) in a small study in China were likely to be positive about attempting treatment-free remission.

The ability to achieve molecular response without receiving any tyrosine kinase inhibitors (TKIs) is becoming a promising strategy for patients with chronic myeloid leukemia (CML). A new study in Patient Preference and Adherence evaluated the characteristics of Chinese patients with CML and their perspectives on attempting treatment-free remission (TFR).

TKIs are a common targeted therapy strategy in CML, but long-term use of these treatments can lead to TKI-related complications. In addition, the cost of these treatments can result in poor adherence. Therefore, patients with CML who have obtained deep molecular remission for a long period of time can attempt to discontinue their TKI treatment to achieve TFR.

“TFR is becoming a target in clinical settings and is estimated to alter the guidelines of managing CML patients in the near future,” the authors explained.


A total of 329 patients with CML participated in the study. The researchers collected information in 5 areas: demographics, diagnosis information, treatment history, quality of life, and TFR preference. The adherence rate was 50% among the patients and the researchers reported that the total medial annual costs for patients were 97,563 CNY (Chinese Yuan), or approximately $14,600.

Only one-third (34%) of patients were willing to attempt TFR positively and 27% were unsure, but willing to try it if their physician recommended it. The top reasons respondents wanted to discontinue their treatment were poor quality of life (56%), high costs (52%), inconvenience (42%), and pregnancy need (41%).

The researchers found that patients who were more likely to be positive about TFR were younger and had shorter disease duration and higher disease symptom burden.

“Our data may help promote the adherence of CML patients by adapting tailored strategies,” the authors wrote. “In addition, our results are important for designing clinical trials and implementation of TFR in the regions where treatment cost of CML was well covered by medical insurances and patient assistance program.”


Lou J, Huang J, Wang Z, et al. Chronic myeloid leukemia patients and treatment-free remission attitudes: a multicenter survey. Patient Prefer Adherence. 2018;12:1025-1032. doi: 10.2147/PPA.S163393.