Early molecular and cytogenetic response is predictive for long-term progression-free and overall survival in chronic myeloid leukemia (CML)

Publisher DOI
PubMed ID
22446502
Abstract
In the face of competing first-line treatment options for CML, early prediction of prognosis on imatinib is desirable to assure favorable survival or otherwise consider the use of a second-generation tyrosine kinase inhibitor (TKI). A total of 1303 newly diagnosed imatinib-treated patients (pts) were investigated to correlate molecular and cytogenetic response at 3 and 6 months with progression-free and overall survival (PFS, OS). The persistence of BCR-ABL transcript levels >10% according to the international scale (BCR-ABL(IS)) at 3 months separated a high-risk group (28% of pts; 5-year OS: 87%) from a group with >1-10% BCR-ABL(IS) (41% of pts; 5-year OS: 94%; P=0.012) and from a group with 1% BCR-ABL(IS) (31% of pts; 5-year OS: 97%; P=0.004). Cytogenetics identified high-risk pts by >35% Philadelphia chromosome-positive metaphases (Ph+, 27% of pts; 5-year OS: 87%) compared with 35% Ph+ (73% of pts; 5-year OS: 95%; P=0.036). At 6 months, >1% BCR-ABL(IS) (37% of pts; 5-year OS: 89%) was associated with inferior survival compared with 1% (63% of pts; 5-year OS: 97%; P<0.001) and correspondingly >0% Ph+ (34% of pts; 5-year OS: 91%) compared with 0% Ph+ (66% of pts; 5-year OS: 97%; P=0.015). Treatment optimization is recommended for pts missing these landmarks.
Date Issued
2012
Publication Type
Article
Language(s)
en
Author(s)
Hanfstein, B
Müller, M C
Hehlmann, R
Erben, P
Lauseker, M
Fabarius, A
Schnittger, S
Haferlach, C
Göhring, G
Proetel, U
Kolb, H-J
Krause, S W
Hofmann, W-K
Schubert, J
Einsele, H
Dengler, J
Hänel, M
Falge, C
Kanz, L
Neubauer, A
Kneba, M
Stegelmann, F
Pfreundschuh, M
Waller, C F
Branford, S
Hughes, T P
Spiekermann, K
Baerlocher, Gabriela M.
Pfirrmann, M
Hasford, J
Saußele, S
Hochhaus, A
Additional Credits
Journal
Leukemia
Publisher
Nature Publishing Group
ISSN
0887-6924
Access(Rights)
metadata.only
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