In:
Cancer Medicine, Wiley, Vol. 7, No. 10 ( 2018-10), p. 5107-5117
Abstract:
The present study aimed to assess the clinical impact of BCR ‐ ABL 1 transcript levels determined at an earlier time point than the 3‐month early molecular response ( EMR ) in chronic‐phase chronic myeloid leukemia ( CML ‐ CP ) patients. BCR ‐ ABL 1 transcript levels of CML ‐ CP patients (n = 258; median age, 43 [range, 18‐81] years) treated with various tyrosine kinase inhibitors ( TKI s) were determined at 4 weeks (28 ± 3 days) and at every 3 months of treatment initiation. At 4 weeks, receiver operating characteristic curves revealed that cutoff values of BCR ‐ ABL 1 transcripts for achieving major molecular responses ( MMR s) by 12 and 60 months were 40.89% and 39.16%, respectively (95% CI , 0.658‐0.772 and 95% CI , 0.643‐0.758; P 〈 0.0001). With 40% of BCR ‐ ABL 1 transcripts at 4 weeks (very early MR ; VEMR ), patients with VEMR achieved higher 3‐month EMR and 4‐week VEMR significantly associated with higher cumulative incidences of 5‐year MMR (89.1% vs 72.3%; P 〈 0.001) and 5‐year deep molecular response ( DMR ) (56.5% vs 29.4%; P = 0.001). Furthermore, event‐free survival ( EFS )‐a (93.0% vs 84.8%; P = 0.068) and EFS ‐b (71.1% vs 57.9%; P = 0.061) by 5 years were also marginally significant. VEMR and 3‐month EMR were achieved in 89 patients, with significantly superior outcomes. In multivariate analyses, lower leukocyte count ( P = 0.008) and frontline second‐generation TKI therapy size ( P 〈 0.001) were significantly associated with VEMR achievement, but not baseline BCR ‐ ABL 1 level and CML duration. In conclusion, the 4‐week BCR ‐ ABL 1 transcript levels including VEMR could be important to predict long‐term outcomes and may provide additional information about innate intrinsic sensitivity to CML among individuals.
Type of Medium:
Online Resource
ISSN:
2045-7634
,
2045-7634
DOI:
10.1002/cam4.2018.7.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2659751-2
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