scholarly journals Significance of suboptimal response to imatinib, as defined by the European LeukemiaNet, in the long-term outcome of patients with early chronic myeloid leukemia in chronic phase

Cancer ◽  
2009 ◽  
Vol 115 (16) ◽  
pp. 3709-3718 ◽  
Author(s):  
Yesid Alvarado ◽  
Hagop Kantarjian ◽  
Susan O'Brien ◽  
Stefan Faderl ◽  
Gautam Borthakur ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Chronic Phase ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Long-term outcome with dasatinib after imatinib failure in chronic-phase chronic myeloid leukemia: follow-up of a phase 3 study

Blood ◽  
2014 ◽  
Vol 123 (15) ◽  
pp. 2317-2324 ◽  
Author(s):  
Neil P. Shah ◽  
François Guilhot ◽  
Jorge E. Cortes ◽  
Charles A. Schiffer ◽  
Philipp le Coutre ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Chronic Phase ◽  
Progression Free Survival ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Imatinib Resistant ◽  
Key Points

Key Points Imatinib-resistant/-intolerant patients with chronic myeloid leukemia in chronic phase can experience long-term benefit with dasatinib. Early (3- and 6-month) molecular and cytogenetic responses were associated with improved progression-free survival and overall survival.

Long-Term Outcome of Nonmyeloablative Allogeneic Stem Cell Transplantation in First Chronic Phase of Chronic Myeloid Leukemia

2006 ◽  
Vol 1 (2) ◽  
pp. 123-129
Author(s):  
Benjamin Gesundheit ◽  
Shimon Slavin ◽  
Michael Y. Shapira ◽  
Menachem Bitan ◽  
Avraham Amar ◽  
...  
Keyword(s):  
Stem Cell ◽  
Chronic Myeloid Leukemia ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Myeloid Leukemia ◽  
Chronic Phase ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Chronic Myeloid Leukemia: Long-Term Outcome Data in the Imatinib Era

2018 ◽  
Vol 35 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Prasanth Ganesan ◽  
Trivadi S. Ganesan ◽  
Venkatraman Radhakrishnan ◽  
Tenali Gnana Sagar ◽  
Krishnarathinam Kannan ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Outcome Data ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Prognostic Significance of Transcript-Type BCR‐ABL1 in Chronic Myeloid Leukemia

2020 ◽  
Vol 12 (1) ◽  
pp. e2020062
Author(s):  
Matteo Molica ◽  
Elisabetta Abruzzese ◽  
Massimo Breccia
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Fusion Gene ◽  
Prognostic Significance ◽  
High Rate ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Molecular Responses

Chronic myeloid leukemia (CML) is characterized by the presence of the BCR-ABL1 fusion gene. In more than 95% of CML patients, the typical BCR-ABL1 transcript subtypes are e13a2 (b2a2), e14a2 (b3a2), or the simultaneous expression of both. Other less frequent transcript subtypes, such as e1a2, e2a2, e6a2, e19a2, e1a3, e13a3, and e14a3, have been sporadically reported. The main purpose of this review is to assess the possible impact of different transcripts on the response rate to tyrosine kinase inhibitors (TKIs), the achievement of stable deep molecular responses (s-DMR), the potential maintenance of treatment-free remission (TFR), and long-term outcome of CML patients treated with TKIs. According to the majority of published studies, patients with e13a2 transcript treated with imatinib have lower and slower cytogenetic and molecular responses than those with e14a2 transcript and should be considered a high-risk group who would mostly benefit from frontline treatment with second-generation TKIs (2GTIKIs). Although few studies have been published, similar significant differences in response rates to 2GTKIs have been not reported. The e14a2 transcript seems to be a favorable prognostic factor for obtaining s-DMR, irrespective of the TKI received, and is also associated with a very high rate of TFR maintenance. Indeed, patients with e13a2 transcript achieve a lower rate of s-DMR and experience a higher probability of TFR failure. According to most reported data in the literature, the type of transcript does not seem to affect long-term outcomes of CML patients treated with TKIs. In TFR, the e14a2 transcript appears to be related to favorable responses. 2GTKIs as frontline therapy might be a convenient approach in patients with e13a2 transcript to achieve optimal long-term outcomes.  

scholarly journals Long-term outcome of a phase 2 trial with nilotinib 400 mg twice daily in first-line treatment of chronic myeloid leukemia

Haematologica ◽  
2015 ◽  
Vol 100 (9) ◽  
pp. 1146-1150 ◽  
Author(s):  
G. Gugliotta ◽  
F. Castagnetti ◽  
M. Breccia ◽  
L. Levato ◽  
M. D'Adda ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Line Treatment ◽  
Phase 2 ◽  
First Line ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Phase 2 Trial ◽  
First Line Treatment

scholarly journals Long-term outcome of chronic myeloid leukemia patients treated frontline with imatinib

Leukemia ◽  
2015 ◽  
Vol 29 (9) ◽  
pp. 1823-1831 ◽  
Author(s):  
F Castagnetti ◽  
◽  
G Gugliotta ◽  
M Breccia ◽  
F Stagno ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Early Molecular Response in Chronic Myeloid Leukemia Patients Predicts Future Response Status

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5529-5529
Author(s):  
Irina Martynkevich ◽  
Vasily Shuvaev ◽  
Ekaterina Petrova ◽  
Lyubov Polushkina ◽  
Lyudmila Martynenko ◽  
...  
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Conflicts Of Interest ◽  
Chronic Phase ◽  
Molecular Response ◽  
Prognostic Impact ◽  
Long Term Outcome ◽  
Transcript Levels ◽  
Optimal Response

Abstract Objectives and background: The level of early MR is important for the optimization of therapy and making a decision to a switch to 2nd line therapy in patients (pts) who have not achieved an optimal response (OR). According to the recent recommendations at definition of OR on CML therapy, pts must have the level of BCR-ABL transcript gene at 10% or less and Ph-positive cells 35% or less at 3 months. But, in half of all cases of pts with BCR-ABL >10% at 3 months progression events happen between 3 and 6 months. The goal of our research was to investigate the prognostic impact of a large BCR-ABL transcript amount at 3 months on the subsequent response and the long-term outcome of CML pts treated frontline with IM. Methods: We have examined 185 pts, who have got IM from January 2010 up to the present. Molecular monitoring has been done regularly in all patients according to ELN recommendations. Median age was 49 years. All pts were in CP. BCR-ABL transcript levels were assessed by real-time quantitative PCR. Results: In our study 54% (100/185 cases) of pts achieved the optimal response with BCR-ABL transcript levels ≤10% at 3 months, 50,3% (93/185 cases) did it - with BCR-ABL transcript levels ≤1% at 6 months, and only 18% achieved the optimal response at 12 months. The comparative analysis has shown statistical differences in all characteristics in 2 groups of pts, who either achieved or not the optimal response at 3 months. Pts with BCR-ABL transcript levels ≤10% more often achieved CCgR at 6 months (g=0,0000), CCgR during all period (g=0,0004), MMR at 12 months (g=0,0000), MMR during all period (g=0,0012) and MR4 during all period (g=0,0000), pts had londer event-free (g=0,0432) and overall (g=0,0279) 4-year survival. Figure 1 Figure 1. In our center we have switched 6 patients to the 2nd TKI - those who didn't achieve the optimal response at 3 months. The switching showed the positive influence on loss level expression of BCR-ABL gene in 5 out of 6 patients. After that all patients achieved the optimal response in the future. For example, we had one patient with failure of IM at 3 months. We switched him the therapy to NI in 5 months after the diagnosis. As a result the patient achieved CCgR at 1,5 months, and the deep molecular response 4,5 log at 3 months. Conclusions: Early and deep responses to TKIs are predictive of long-term response and favorable survival outcomes. 3-month reduction in BCR-ABL transcript levels to >10% is a factor of bad effectiveness of TKI therapy and requires switching to the 2nd TKI. Timely switching to the 2nd TKIs allows us to achieve an optimal response in CML patients with level BCR-ABL >10% at 3 months. References: Timothy P. Hughes, Giuseppe Saglio, Hagop M. Kantarjian et al. Early molecular response predicts outcomes in patients with chronic myeloid leukemia in chronic phase treated with frontline nilotinib or imatinib. Blood, 27 February 2014 x Volume 123, Number 9. Disclosures No relevant conflicts of interest to declare.

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