Patient-Initiated Discontinuation of Tyrosine Kinase Inhibitor for Chronic Myeloid Leukemia.

The introduction of tyrosine kinase inhibitors (TKI) has revolutionised the management of patients with chronic myeloid leukemia (CML) over the last twenty years, but despite significant improvements in survival, patients exhibit long-term side effects that impact on quality of life. A major advance in CML management has been the ability to discontinue TKI therapy achieving a treatment-free remission (TFR), yet this option is only available to eligible patients who present with low-risk disease and who subsequently attain deep and sustained molecular responses. A case is described of a patient with CML who self-initiated stopping of TKI therapy when in a less than optimal molecular remission.

QT dispersion, QT maximum and risk of cardiac death in the Caerphilly Heart Study.

Background: It has been postulated that increased inter-lead differences in QT interval (QT dispersion) and the maximum QT interval (QTmax), in the standard 12-lead electrocardiogram (ECG), may be associated with an increased risk of cardiac death. The aims of this study were to assess the relationship between QT dispersion and QTmax, corrected and uncorrected for heart rate, and the risk of cardiac death.

Design: Nested case-control study within the Caerphilly prospective cohort study.