Clinical Implications of Discordant Early Molecular Responses in CML Patients Treated with Imatinib
In: International Journal of Molecular Sciences International Journal of Molecular Sciences, Jg. 20 (2019), Heft 9, p 2226
Online
unknown
Zugriff:
A reduction in BCR-ABL1/ABL1IS transcript levels to <
10% after 3 months or <
1% after 6 months of tyrosine kinase inhibitor therapy are associated with superior clinical outcomes in chronic myeloid leukemia (CML) patients. In this study, we investigated the reliability of multiple BCR-ABL1 thresholds in predicting treatment outcomes for 184 subjects diagnosed with CML and treated with standard-dose imatinib mesylate (IM). With a median follow-up of 61 months, patients with concordant BCR-ABL1/ABL1IS transcripts below the defined thresholds (10% at 3 months and 1% at 6 months) displayed significantly superior rates of event-free survival (86.1% vs. 26.6%) and deep molecular response (&ge
MR4
71.5% vs. 16.1%) compared to individuals with BCR-ABL1/ABL1IS levels above these defined thresholds. We then analyzed the outcomes of subjects displaying discordant molecular transcripts at 3- and 6-month time points. Among these patients, those with BCR-ABL1/ABL1IS values >
10% at 3 months but <
1% at 6 months fared significantly better than individuals with BCR-ABL1/ABL1IS <
10% at 3 months but >
1% at 6 months (event-free survival 68.2% vs. 32.7%
p <
0.001). Likewise, subjects with BCR-ABL1/ABL1IS at 3 months >
10% but <
1% at 6 months showed a higher cumulative incidence of MR4 compared to patients with BCR-ABL1/ABL1IS <
1% at 6 months (75% vs. 18.2%
0.001). Finally, lower BCR-ABL1/GUSIS transcripts at diagnosis were associated with BCR-ABL1/ABL1IS values <
1% at 6 months (p <
0.001). Our data suggest that when assessing early molecular responses to therapy, the 6-month BCR-ABL1/ABL1IS level displays a superior prognostic value compared to the 3-month measurement in patients with discordant oncogenic transcripts at these two pivotal time points.
Titel: |
Clinical Implications of Discordant Early Molecular Responses in CML Patients Treated with Imatinib
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Autor/in / Beteiligte Person: | Musolino, Caterina ; Tirrò, Elena ; Antolino, Agostino ; Martino, Bruno ; Massimino, Michele ; Zammit, Valentina ; Siracusa, Sergio ; Spitaleri, Antonio ; Impera, Stefana ; Maria Stella Pennisi ; Accurso, Vincenzo ; Musso, Maurizio ; Mineo, Giuseppe ; Porretto, Ferdinando ; Stella, Stefania ; Forte, Stefano ; Francesco Di Raimondo ; Silvia Rita Vitale ; Russo, Sabina ; Stagno, Fabio ; Manzella, Livia ; Vigneri, Paolo ; Malato, Alessandra ; Mannina, Donato ; Stella, S. ; Zammit, V. ; S.R., Vitale ; M.S., Pennisi ; Massimino, M. ; Tirro, E. ; Forte, S. ; Spitaleri, A. ; Antolino, A. ; Siragusa, S. ; Accurso, V. ; Mannina, D. ; Impera, S. ; Musolino, C. ; Russo, S. ; Malato, A. ; Mineo, G. ; Musso, M. ; Porretto, F. ; Martino, B. ; Di Raimondo F. ; Manzella, L. ; Vigneri, P. ; Stagno, F. |
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Zeitschrift: | International Journal of Molecular Sciences International Journal of Molecular Sciences, Jg. 20 (2019), Heft 9, p 2226 |
Veröffentlichung: | 2019 |
Medientyp: | unknown |
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