Prognostic impact of deletions of derivative chromosome 9 in patients with chronic myelogenous leukemia treated with nilotinib or dasatinib
| Autor: | Hagop M. Kantarjian, Jorge E. Cortes, Alfonso Quintás-Cardama, Srdan Verstovsek, Jianqin Shan, Elias Jabbour, Guillermo Garcia-Manero, Susan O'Brien, Lynne V. Abruzzo |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Adolescent Derivative chromosome Dasatinib Antineoplastic Agents Disease-Free Survival Article Leukemia Myelogenous Chronic BCR-ABL Positive hemic and lymphatic diseases Internal medicine Humans Medicine Protein Kinase Inhibitors Aged Sequence Deletion Aged 80 and over business.industry Myeloid leukemia Cancer Imatinib Middle Aged Protein-Tyrosine Kinases Prognosis medicine.disease Transplantation Thiazoles Pyrimidines Treatment Outcome Nilotinib Immunology Female Chromosomes Human Pair 9 business medicine.drug Chronic myelogenous leukemia |
| Zdroj: | Cancer. 117:5085-5093 |
| ISSN: | 0008-543X |
| DOI: | 10.1002/cncr.26147 |
| Popis: | BACKGROUND: Deletions of derivative chromosome 9 are a poor prognostic factor in patients with chronic myeloid leukemia (CML) treated with hydroxyurea, interferon, or stem cell transplantation. Imatinib may overcome the adverse prognostic impact of deletions of derivative chromosome 9. METHODS: A study was undertaken to investigate the prognostic impact of deletions of derivative chromosome 9 in 353 patients with CML receiving the second generation tyrosine kinase inhibitors (TKIs) nilotinib (n = 161) or dasatinib (n = 192). RESULTS: Deletion of derivative chromosome 9 status was determined in 245 (69%). Twenty-eight (11%) patients, 22 in chronic phase, 4 in accelerated phase, and 2 in blast phase, carried deletions of derivative chromosome 9, including 17 receiving nilotinib and 11 receiving dasatinib (P = .47). Overall survival (OS) at 24 months was similar between patients with or without deletions of derivative chromosome 9 (70% vs 71%, P = .76). For patients in chronic phase, no significant differences in overall major cytogenetic response (77% vs 82%, P = .57) or complete cytogenetic response (77% vs 81%, P = .71) rates were observed between patients with or without deletions of derivative chromosome 9. At 24 months, patients with CML in chronic phase without deletions of derivative chromosome 9 had improved event-free survival (EFS) (88% vs 66%, P = .07) and OS (96% vs 82%; P = .08) compared with those carrying deletions of derivative chromosome 9. However, multivariate analysis established second-line versus frontline second generation TKI therapy as the only adverse prognostic factor for EFS and increased bone marrow blast burden and older age as independent adverse prognostic factors for OS. CONCLUSIONS: Deletions of derivative chromosome 9 do not appear to be an independent risk factor for survival among patients with CML in chronic phase receiving second generation TKIs. Cancer 2011;. © 2011 American Cancer Society. |
| Databáze: | OpenAIRE |
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