Assessment of BCR-ABL1 transcript levels at 3 months is the only requirement for predicting outcome for patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors.
Purpose: We studied BCR-ABL1 transcript levels in patients with chronic myeloid leukemia in chronic phase (CML-CP) at 3, 6, and 12 months after starting imatinib to identify molecular milestones that would predict for overall survival (OS) and other outcomes more reliably than serial marrow cytogene...
| Publicado en: | Journal of Clinical Oncology Vol. 30; no. 3; pp. 232 - 239 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
American Society of Clinical Oncology
1/20/2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104630098&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104630098 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0732183X 20D jtl: Journal of Clinical Oncology issn: 0732183X maglogo: N pubinfo: dt: 1/20/2012 vid: 30 iid: 3 pid: 26892 pub: American Society of Clinical Oncology place: Alexandria, Virginia artinfo: ui: 104630098 NLM22067393 2011431277 10.1200/JCO.2011.38.6565 NLM22067393 104630098 ppf: 232 ppct: 7 formats: tig: atl: Assessment of BCR-ABL1 transcript levels at 3 months is the only requirement for predicting outcome for patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors. aug: au: Marin D Ibrahim AR Lucas C Gerrard G Wang L Szydlo RM Clark RE Apperley JF Milojkovic D Bua M Pavlu J Paliompeis C Reid A Rezvani K Goldman JM Foroni L Marin, David Ibrahim, Amr R Lucas, Claire Gerrard, Gareth affil: Department of Haematology, Imperial College London, Hammersmith Hospital, Du Cane Rd, London W12 0NN, United Kingdom sug: subj: Proteins Leukemia, Myeloid, Chronic Drug Therapy Leukemia, Myeloid, Chronic Heterocyclic Compounds Therapeutic Use Transferases Antagonists and Inhibitors Adolescence Adult Aged Aged, 80 and Over Antineoplastic Agents Therapeutic Use Prognosis Female Human Male Middle Age Enzyme Inhibitors Therapeutic Use RNA Treatment Outcomes Young Adult Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Purpose: We studied BCR-ABL1 transcript levels in patients with chronic myeloid leukemia in chronic phase (CML-CP) at 3, 6, and 12 months after starting imatinib to identify molecular milestones that would predict for overall survival (OS) and other outcomes more reliably than serial marrow cytogenetics.Patients and Methods: We analyzed 282 patients with CML-CP who received imatinib 400 mg/d as first-line therapy followed by dasatinib or nilotinib if treatment with imatinib failed. We used a receiver operating characteristic curve to identify the cutoffs in transcript levels at 3, 6, and 12 months that would best predict patient outcome. We validated our findings in an independent cohort of 95 patients treated elsewhere.Results: Patients with transcript levels of more than 9.84% (n = 68) at 3 months had significantly lower 8-year probabilities of OS (56.9% v 93.3%; P < .001), progression-free survival, cumulative incidence of complete cytogenetic response, and complete molecular response than those with higher transcript levels. Similarly, transcript levels of more than 1.67% (n = 87) at 6 months and more than 0.53% (n = 93) at 12 months identified high-risk patients. However, transcript levels at 3 months were the most strongly predictive for the various outcomes. When we compared OS for the groups defined molecularly at 6 and 12 months with the usual cytogenetic milestones, categorization by transcript numbers was the only independent predictor for OS (relative risk, 0.207; P < .001 and relative risk, 0.158; P < .001, respectively).Conclusion: A single measurement of BCR-ABL1 transcripts performed at 3 months is the best way to identify patients destined to fare poorly, thereby allowing early clinical intervention. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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