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Blood, 1 November 2004, Vol. 104, No. 9, pp. 2926-2932. Prepublished online as a Blood First Edition Paper on July 15, 2004; DOI 10.1182/blood-2004-03-1134. This Article Full Text Full Text (PDF) All Versions of this Article: 2004-03-1134v1 104/9/2926    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Branford, S. Articles by Hughes, T. Search for Related Content PubMed PubMed Citation Articles by Branford, S. Articles by Hughes, T. Related Collections Neoplasia Oncogenes and Tumor Suppressors Gene Expression Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  NEOPLASIA Real-time quantitative PCR analysis can be used as a primary screen to identify patients with CML treated with imatinib who have BCR-ABL kinase domain mutations Susan Branford, Zbigniew Rudzki, Ian Parkinson, Andrew Grigg, Kerry Taylor, John F. Seymour, Simon Durrant, Peter Browett, Anthony P. Schwarer, Chris Arthur, John Catalano, Michael F. Leahy, Robin Filshie, Kenneth Bradstock, Richard Herrmann, David Joske, Kevin Lynch, and Tim Hughes From the Institute of Medical and Veterinary Science, Adelaide, Australia; the Royal Melbourne Hospital, Melbourne, Australia; the Mater Hospital, Brisbane, Queensland, Australia; the Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; the Royal Brisbane Hospital, Brisbane, Australia; the Auckland Hospital, Auckland, New Zealand; The Alfred Hospital, Melbourne, Victoria, Australia; the Royal North Shore Hospital, Sydney, New South Wales, Australia; the Monash Medical Centre, Melbourne, Victoria, Australia; the Fremantle Hospital, Fremantle, Western Australia, Australia; the St Vincent's Hospital, Melbourne, Victoria, Australia; the Westmead Hospital, Sydney, New South Wales, Australia; the Royal Perth Hospital, Perth, Australia; the Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; the Novartis Pharmaceuticals Australia, Sydney, Australia. Mutations within the BCR-ABL kinase domain in imatinib-treated chronic myeloid leukemia (CML) are the main mechanism of acquired resistance. The early detection of mutations should provide clinical benefit by allowing early intervention. Quantitative polymerase chain reaction (RQ-PCR) results of BCR-ABL mRNA were correlated with mutation analysis in 214 patients treated with imatinib. We determined whether there was a difference in the incidence of mutations between the patients with a more than 2-fold rise in BCR-ABL and patients with stable or decreasing levels. Of the 56 patients with a more than 2-fold rise, 34 (61%) had detectable mutations (median rise, 3.0-fold; 25th-75th percentiles, 2.3-5.2). In 31 (91%) of these 34 patients, the mutation was present at the time of the rise and became detectable within 3 months in the remaining patients. Only 1 (0.6%) of 158 patients with stable or decreasing BCR-ABL levels had a detectable mutation, P less than .0001. Thus, a more than 2-fold rise identified 34 (97%) of 35 patients with a mutation. We conclude that a rise in BCR-ABL of more than 2-fold can be used as a primary indicator to test patients for BCR-ABL kinase domain mutations. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: R. D. Press, S. G. Willis, J. Laudadio, M. J. Mauro, and M. W. N. Deininger Determining the rise in BCR-ABL RNA that optimally predicts a kinase domain mutation in patients with chronic myeloid leukemia on imatinib Blood, September 24, 2009; 114(13): 2598 - 2605. [Abstract] [Full Text] [PDF] E. Mattarucchi, O. Spinelli, A. Rambaldi, F. Pasquali, F. Lo Curto, L. Campiotti, and G. Porta Molecular Monitoring of Residual Disease in Chronic Myeloid Leukemia by Genomic DNA Compared with Conventional mRNA Analysis J. Mol. Diagn., September 1, 2009; 11(5): 482 - 487. [Abstract] [Full Text] [PDF] H. M. Kantarjian, J. Shan, D. Jones, S. 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[Abstract] [Full Text] [PDF] S. Branford, L. Fletcher, N. C. P. Cross, M. C. Muller, A. Hochhaus, D.-W. Kim, J. P. Radich, G. Saglio, F. Pane, S. Kamel-Reid, et al. Desirable performance characteristics for BCR-ABL measurement on an international reporting scale to allow consistent interpretation of individual patient response and comparison of response rates between clinical trials Blood, October 15, 2008; 112(8): 3330 - 3338. [Abstract] [Full Text] [PDF] J. S. Khorashad, H. de Lavallade, J. F. Apperley, D. Milojkovic, A. G. Reid, M. Bua, R. Szydlo, E. Olavarria, J. Kaeda, J. M. Goldman, et al. Finding of Kinase Domain Mutations in Patients With Chronic Phase Chronic Myeloid Leukemia Responding to Imatinib May Identify Those at High Risk of Disease Progression J. Clin. Oncol., October 10, 2008; 26(29): 4806 - 4813. [Abstract] [Full Text] [PDF] D. M. Ross, D. B. Watkins, T. P. Hughes, and S. 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