Cytogenetic and molecular responses and outcome in chronic myelogenous leukemia: need for new response definitions?

Abstract:

BACKGROUND:Response rates in chronic myeloid leukemia (CML) are now reported based on the cumulative incidence of a single-time best response. The study aim was to examine the significance of different response criteria for CML on imatinib therapy. METHODS:In all, 276 patients with chronic phase CML on imatinib therapy were analyzed. Cytogenetic and molecular responses were coded as to single best response and response at specific intervals of treatment. RESULTS:The cumulative incidence of complete cytogenetic response (CGCR) with imatinib was 91%; however, the incidence of CGCR at 48 months into therapy was only 78%. Similarly, the incidence of major molecular responses (best cumulative vs landmark at 48 months) were 74% versus 62%, and of undetectable BCR-ABL transcripts 38% versus 24%. There was a strong association between achievement of major cytogenetic response (Philadelphia chromosome [Ph]-positivity or=12 months) were associated with longer PFS duration but not with survival duration differences. Of interest, major molecular responses documented at least twice were noted in 71% of patients on imatinib therapy; undetectable BCR-ABL transcripts documented at least twice were noted in 34%. CONCLUSIONS:Achievement and durability of CGCR and of major and complete molecular responses at landmark times predict outcome in CML, and may help in comparing the efficacy of different treatments.

journal_name

Cancer

journal_title

Cancer

authors

Kantarjian H,O'Brien S,Shan J,Huang X,Garcia-Manero G,Faderl S,Ravandi-Kashani F,Verstovsek S,Beth Rios M,Cortes J

doi

10.1002/cncr.23238

subject

Has Abstract

pub_date

2008-02-15 00:00:00

pages

837-45

issue

4

eissn

0008-543X

issn

1097-0142

journal_volume

112

pub_type

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