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Defining therapy goals for major molecular remission in chronic myeloid leukemia: results of the randomized CML Study IV.

Abstract：

:Major molecular remission (MMR) is an important therapy goal in chronic myeloid leukemia (CML). So far, MMR is not a failure criterion according to ELN management recommendation leading to uncertainties when to change therapy in CML patients not reaching MMR after 12 months. At monthly landmarks, for different molecular remission status Hazard ratios (HR) were estimated for patients registered to CML study IV who were divided in a learning and a validation sample. The minimum HR for MMR was found at 2.5 years with 0.28 (compared to patients without remission). In the validation sample, a significant advantage for progression-free survival (PFS) for patients in MMR could be detected (p-value 0.007). The optimal time to predict PFS in patients with MMR could be validated in an independent sample at 2.5 years. With our model we provide a suggestion when to define lack of MMR as therapy failure and thus treatment change should be considered. The optimal response time for 1% BCR-ABL at about 12-15 months was confirmed and for deep molecular remission no specific time point was detected. Nevertheless, it was demonstrated that the earlier the MMR is achieved the higher is the chance to attain deep molecular response later.

journal_name

Leukemia

journal_title

Leukemia

authors

Saussele S,Hehlmann R,Fabarius A,Jeromin S,Proetel U,Rinaldetti S,Kohlbrenner K,Einsele H,Falge C,Kanz L,Neubauer A,Kneba M,Stegelmann F,Pfreundschuh M,Waller CF,Oppliger Leibundgut E,Heim D,Krause SW,Hofmann WK,Has

doi

10.1038/s41375-018-0055-7

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

1222-1228

issue

5

eissn

0887-6924

issn

1476-5551

pii

10.1038/s41375-018-0055-7

journal_volume

32

pub_type

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