PMID- 31171474
OWN - NLM
STAT- MEDLINE
DCOM- 20200806
LR  - 20200806
IS  - 2152-2669 (Electronic)
IS  - 2152-2669 (Linking)
VI  - 19
IP  - 8
DP  - 2019 Aug
TI  - Musculoskeletal Pain in Patients With Chronic Myeloid Leukemia After Tyrosine 
      Kinase Inhibitor Therapy Cessation.
PG  - 480-487
LID - S2152-2650(19)30167-3 [pii]
LID - 10.1016/j.clml.2019.05.007 [doi]
AB  - Clinical trials have shown that for some patients with chronic myeloid leukemia 
      in chronic phase receiving tyrosine kinase inhibitors (TKIs), treatment-free 
      remission (TFR) is achievable and safe. TFR is now a treatment goal for select 
      patients who have experienced a sustained deep molecular response. An expected 
      result of TFR would be a decrease in the frequency or intensity of adverse events 
      (AEs) associated with TKI therapy. Unexpectedly, however, some clinical trials 
      have reported new or worsening AEs, typically described as musculoskeletal pain, 
      in patients attempting TFR. These AEs are hypothesized to be a TKI withdrawal 
      syndrome, although the underlying mechanism is not known. Overall, 
      musculoskeletal pain has been reported in approximately 20% to 30% of patients 
      attempting TFR and is typically transient and easily managed. TKI cessation would 
      be expected to improve patients' quality of life (QOL); however, in studies 
      assessing QOL, patients have reported little change after ceasing TKI therapy, 
      perhaps because they must tolerate long-term TKI therapy before they can attempt 
      TFR. Here we review reports of musculoskeletal pain during TFR and changes in QOL 
      after TKI cessation in clinical trials. As more patients attempt TFR in routine 
      practice, the health care community will play an important role in helping these 
      patients understand the benefits and risks of TFR, the effect it may have on 
      their QOL, and the potential for musculoskeletal pain.
CI  - Copyright (c) 2019 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Kota, Vamsi
AU  - Kota V
AD  - Section of Hematology and Oncology, Georgia Cancer Center, Augusta University, 
      Augusta, GA. Electronic address: vkota@augusta.edu.
FAU - Atallah, Ehab
AU  - Atallah E
AD  - Division of Hematology/Oncology, Medical College of Wisconsin and Froedtert 
      Hospital, Milwaukee, WI.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190513
PL  - United States
TA  - Clin Lymphoma Myeloma Leuk
JT  - Clinical lymphoma, myeloma & leukemia
JID - 101525386
RN  - 0 (Protein Kinase Inhibitors)
RN  - EC 2.7.10.2 (Fusion Proteins, bcr-abl)
SB  - IM
MH  - Fusion Proteins, bcr-abl/*antagonists & inhibitors
MH  - Humans
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/*drug therapy/pathology
MH  - Molecular Targeted Therapy/*adverse effects
MH  - Musculoskeletal Pain/chemically induced/*pathology
MH  - Prognosis
MH  - Protein Kinase Inhibitors/*adverse effects
MH  - *Quality of Life
MH  - Withholding Treatment
OTO - NOTNLM
OT  - Adverse event
OT  - Quality of life
OT  - Treatment-free remission
OT  - Trial
OT  - Withdrawal syndrome
EDAT- 2019/06/07 06:00
MHDA- 2020/08/07 06:00
CRDT- 2019/06/08 06:00
PHST- 2019/02/11 00:00 [received]
PHST- 2019/04/29 00:00 [revised]
PHST- 2019/05/07 00:00 [accepted]
PHST- 2019/06/07 06:00 [pubmed]
PHST- 2020/08/07 06:00 [medline]
PHST- 2019/06/08 06:00 [entrez]
AID - S2152-2650(19)30167-3 [pii]
AID - 10.1016/j.clml.2019.05.007 [doi]
PST - ppublish
SO  - Clin Lymphoma Myeloma Leuk. 2019 Aug;19(8):480-487. doi: 
      10.1016/j.clml.2019.05.007. Epub 2019 May 13.