Patients with chronic myeloid leukemia who maintain a complete molecular response after stopping imatinib treatment have evidence of persistent leukemia by DNA PCR
| Autor: | John F. Seymour, Cassandra Slader, Anthony K. Mills, Susan Branford, Phuong Dang, Junia V. Melo, Timothy P. Hughes, Robin Filshie, Chani Field, Christopher Arthur, Andrew Grigg, Paul A. Bartley, David M. Ross, Anthony P. Schwarer |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty medicine.drug_class Fusion Proteins bcr-abl Graft vs Host Disease Antineoplastic Agents Polymerase Chain Reaction Sensitivity and Specificity Piperazines Tyrosine-kinase inhibitor Leukemia Myelogenous Chronic BCR-ABL Positive hemic and lymphatic diseases Internal medicine medicine Humans Aged Hematology business.industry Remission Induction Myeloid leukemia Imatinib DNA Neoplasm Middle Aged medicine.disease Minimal residual disease Survival Rate Leukemia Pyrimidines Treatment Outcome Imatinib mesylate Oncology Benzamides Imatinib Mesylate Cancer research Female business Follow-Up Studies medicine.drug Chronic myelogenous leukemia |
| Zdroj: | Leukemia. 24:1719-1724 |
| ISSN: | 1476-5551 0887-6924 |
| DOI: | 10.1038/leu.2010.185 |
| Popis: | Around 40-50% of patients with chronic myeloid leukemia (CML) who achieve a stable complete molecular response (CMR; undetectable breakpoint cluster region-Abelson leukemia gene human homolog 1 (BCR-ABL1) mRNA) on imatinib can stop therapy and remain in CMR, at least for several years. This raises the possibility that imatinib therapy may not need to be continued indefinitely in some CML patients. Two possible explanations for this observation are (1) CML has been eradicated or (2) residual leukemic cells fail to proliferate despite the absence of ongoing kinase inhibition. We used a highly sensitive patient-specific nested quantitative PCR to look for evidence of genomic BCR-ABL1 DNA in patients who sustained CMR after stopping imatinib therapy. Seven of eight patients who sustained CMR off therapy had BCR-ABL1 DNA detected at least once after stopping imatinib, but none has relapsed (follow-up 12-41 months). BCR-ABL1 DNA levels increased in all of the 10 patients who lost CMR soon after imatinib cessation, whereas serial testing of patients in sustained CMR showed a stable level of BCR-ABL1 DNA. This more sensitive assay for BCR-ABL1 provides evidence that even patients who maintain a CMR after stopping imatinib may harbor residual leukemia. A search for intrinsic or extrinsic (for example, immunological) causes for this drug-free leukemic suppression is now indicated. |
| Databáze: | OpenAIRE |
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