Effects of Deeper Molecular Responses on Outcomes in Chronic Myeloid Leukemia Patients in Chronic Phase Treated With Imatinib Mesylate
| Autor: | Tayfur Toptas, Osman Kara, Isik Kaygusuz Atagunduz, Toluy Ozgumus, Aslihan Sezgin, Fatma Gecgel, Tulin Firatli Tuglular, Rabia Deniz, Ali Eser |
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| Rok vydání: | 2016 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Adolescent Fusion Proteins bcr-abl Antineoplastic Agents Blastic Phase Disease-Free Survival 03 medical and health sciences Cytogenetics Young Adult 0302 clinical medicine Internal medicine Leukemia Myelogenous Chronic BCR-ABL Positive medicine Humans Clinical significance Progression-free survival Aged Retrospective Studies Aged 80 and over business.industry Myeloid leukemia Retrospective cohort study Imatinib Hematology Middle Aged Prognosis Surgery Imatinib mesylate 030220 oncology & carcinogenesis Molecular Response Imatinib Mesylate Female business 030215 immunology medicine.drug |
| Zdroj: | Clinical lymphoma, myelomaleukemia. 17(2) |
| ISSN: | 2152-2669 |
| Popis: | Background The prognostic significance of complete cytogenetic response (CCyR) is well defined in patients with chronic phase chronic myeloid leukemia treated with imatinib as first-line therapy. However, the effect on outcomes of obtaining molecular response itself and the depth of it is not clear. In this study we aimed to determine the frequency of complete molecular response (CMR) during long-term follow-up and the clinical significance of CMR on patient outcomes and survival. Patients and Methods We retrospectively evaluated the files of 178 chronic phase chronic myeloid leukemia patients using imatinib therapy. Forty-seven patients with missing data were excluded from the study and the assessment was done in 131 patients. CMR was defined as undetectable BCR-ABL transcripts using real-time quantitative polymerase chain reaction with a sensitivity level of ≥ 10 4 in 2 consecutive analyses at least 3 months apart. Cytogenetic and molecular monitoring during treatment was performed according to the European LeukemiaNet recommendations criteria. Our primary objective was to analyze the association of deeper molecular response with differences in progression-free survival (PFS). Results Eighty-eight patients (67%) achieved CMR at any time in a median of 65 months of follow-up. The rate of CMR was higher in patients who achieved CCyR at 12 months and major molecular response (MMR) at 18 months. Fewer events occurred in the CMR group than the MMR group (26.1% vs. 50.0%). Overall survival was not different in both groups. CMR was associated with longer PFS with borderline significance. Conclusion Prolonged imatinib therapy helps to achieve a deeper molecular response in the long-term. Achieving deeper molecular response at any time positively affects maintaining the cytogenetic and molecular responses, and decreases the transformation to accelerated and/or blastic phase. The slight prolongation in PFS did not reach statistical significance. |
| Databáze: | OpenAIRE |
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