TY - JOUR
T1 - Musculoskeletal Pain in Patients With Chronic Myeloid Leukemia After Tyrosine Kinase Inhibitor Therapy Cessation
AU - Kota, V.
AU - Atallah, Ehab
N1 - Funding Information:
V.K. reports nonfinancial support from ArticulateScience LLC related to the submitted work (assistance with document preparation) and personal fees from Novartis, Pfizer, Incyte, Xcenda, and Bristol-Myers Squibb outside the submitted work. E.A. reports nonfinancial support from ArticulateScience LLC related to the submitted work (assistance with document preparation) and personal fees from Bristol-Myers Squibb, Novartis, and Pfizer, and grants and personal fees from Takeda outside the submitted work. This review article was developed with editorial assistance from professional medical writers, funded by Novartis Pharmaceuticals Corporation; however, the authors maintained full control over the content of the report.Financial support for medical editorial assistance was provided by Novartis Pharmaceuticals Corporation. We thank Christopher Edwards, PhD, and Karen Kaluza Smith, PhD, ArticulateScience LLC, for their medical editorial assistance.
Funding Information:
V.K. reports nonfinancial support from ArticulateScience LLC related to the submitted work (assistance with document preparation) and personal fees from Novartis, Pfizer, Incyte, Xcenda, and Bristol-Myers Squibb outside the submitted work. E.A. reports nonfinancial support from ArticulateScience LLC related to the submitted work (assistance with document preparation) and personal fees from Bristol-Myers Squibb, Novartis, and Pfizer, and grants and personal fees from Takeda outside the submitted work. This review article was developed with editorial assistance from professional medical writers, funded by Novartis Pharmaceuticals Corporation ; however, the authors maintained full control over the content of the report.
Publisher Copyright:
© 2019 The Authors
PY - 2019/8
Y1 - 2019/8
N2 - 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.
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.
KW - Adverse event
KW - Quality of life
KW - Treatment-free remission
KW - Trial
KW - Withdrawal syndrome
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U2 - 10.1016/j.clml.2019.05.007
DO - 10.1016/j.clml.2019.05.007
M3 - Review article
C2 - 31171474
AN - SCOPUS:85066428575
SN - 2152-2650
VL - 19
SP - 480
EP - 487
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 8
ER -
