Early molecular response evaluation after 3 months of imatinib therapy in patients with chronic myeloid leukemia can contribute to estimation of prognosis – single centre experience

Czech version

Authors: Š. Rožmanová; P. Rohoň; M. Divoká; J. Gazdová; M. Holzerová; I. Marešová; M. Jarošová; E. Faber; K. Indrák
Authors‘ workplace: Hemato-onkologická klinika FN a LF UP Olomouc
Published in: Transfuze Hematol. dnes,18, 2012, No. 2, p. 66-71.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

Retrospective analysis of 54 adult patients with chronic myeloid leukemia in chronic phase treated with imatinib mesylate (IM) in first line is focused on evaluation of prognostic value of early molecular response after 3 months therapy as a predictive landmark of rate achievement optimal IM response. Treatment response was evaluated in cytogenetic and molecular analysis with application of European LeukemiaNet (ELN) 2009 criteria. The follow-up was 12 to 95 months (median 37 months). Estimated progression-free survival (PFS), event-free survival (EFS) and overall survival (OS) at 5 years were 80%, 71% a 89%. At 18 months, cumulative incidence of complete cytogenetic response (CCyR) and major molecular response (MMR) were 81% and 56%, respectively. According to ELN criteria; 32 patients (59%) achieved an optimal and 13 patients (24%) had a suboptimal response while 9 patients (17%) failed IM. Patients were divided into 3 categories according to the results of BCR-ABL transcript levels after 3 months IM therapy: ≤ 1,0% (12 patients), > 1,0 to ≤ 10% (26 patients) and > 10% (16 patients). Comparing these groups of patients it was revealed that patients with lower BCR-ABL (IS) levels after 3 months IM therapy had a significantly higher probability of subsequently obtaining a CCyR (p<0.0001) and MMR (p<0.0001) than patients with higher transcript levels. When we evaluated IM response according to the ELN criteria it was demonstrated that the degree of molecular response after 3 months determined patients quickly achieved optimal treatment response. Early evaluation of molecular response after 3 months of IM therapy in patients with CML can identify patients who early achieve CCyR and MMR.

Key words:
chronic myeloid leukemia, imatinib, molecular response

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