Chronic Myeloid Leukemia (CML) patients with concordant cytogenetic and molecular optimal response at the earliest time-points of imatinib treatment have an excellent probability of obtaining subsequent major molecular response (MMR), deeper MR and favourable long-term FFS. In particular, patients with CCyR and BCR/ABL1 <1% (i.e. concordant optimal response) at 6 months of standard dose imatinib had 3-year FFS of 95.8% (95%CI: 91.7-99.8), which is comparable to that reported in patients treated with different TKIs, including nilotinib and dasatinib. Conversely, patients with at least one warning test at 3 or 6 months have an inferior outcome, not statistically different to that observed in cases with both cytogenetic and molecular warning results. We therefore suggest that CML patients not attaining both cytogenetic and molecular optimal response, as defined by the 2013 ELN recommendations, after 3 and 6 months of imatinib, might be considered at higher risk of treatment failure.

Imatinib-treated chronic myeloid leukemia patients with discordant response between cytogenetic and molecular tests at 3 and 6 month time-points have a reduced probability of subsequent optimal response

BONIFACIO, Massimiliano;SCAFFIDI, Luigi;FRISON, LUCA;KRAMPERA, Mauro;AMBROSETTI, Achille;
2015-01-01

Abstract

Chronic Myeloid Leukemia (CML) patients with concordant cytogenetic and molecular optimal response at the earliest time-points of imatinib treatment have an excellent probability of obtaining subsequent major molecular response (MMR), deeper MR and favourable long-term FFS. In particular, patients with CCyR and BCR/ABL1 <1% (i.e. concordant optimal response) at 6 months of standard dose imatinib had 3-year FFS of 95.8% (95%CI: 91.7-99.8), which is comparable to that reported in patients treated with different TKIs, including nilotinib and dasatinib. Conversely, patients with at least one warning test at 3 or 6 months have an inferior outcome, not statistically different to that observed in cases with both cytogenetic and molecular warning results. We therefore suggest that CML patients not attaining both cytogenetic and molecular optimal response, as defined by the 2013 ELN recommendations, after 3 and 6 months of imatinib, might be considered at higher risk of treatment failure.
Chronic Myeloid Leukemia, cytogenetic response, molecular response, prognosis
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/930457
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