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Blood, 21 May 2009, Vol. 113, No. 21, pp. 5058-5063. Prepublished online as a Blood First Edition Paper on March 12, 2009; DOI 10.1182/blood-2008-10-184960. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-10-184960v1 113/21/5058    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 CrossRef Citing Articles via Google Scholar Google Scholar Articles by Fava, C. Articles by Cortes, J. Search for Related Content PubMed PubMed Citation Articles by Fava, C. Articles by Cortes, J. Related Collections Free Research Articles Myeloid Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Failure to achieve a complete hematologic response at the time of a major cytogenetic response with second-generation tyrosine kinase inhibitors is associated with a poor prognosis among patients with chronic myeloid leukemia in accelerated or blast phase Carmen Fava1, Hagop M. Kantarjian1, Elias Jabbour1, Susan O'Brien1, Nitin Jain1, Mary Beth Rios1, Guillermo Garcia-Manero1, Farhad Ravandi1, Srdan Verstovsek1, Gautam Borthakur1, Jianqin Shan1, and Jorge Cortes1 1 Department of Leukemia, M. D. Anderson Cancer Center, Houston, TX Second-generation tyrosine kinase inhibitors are effective in Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL) and chronic myeloid leukemia (CML). Occasionally, patients with Ph+ ALL, or accelerated phase (AP) or blast phase (BP) CML achieve a major cytogenetic response (MCyR) but not a complete hematologic response (CHR). We analyzed 126 patients with CML in AP or BP, or with Ph+ ALL treated with dasatinib or nilotinib after imatinib failure. Twenty patients received sequential treatment with both dasatinib and nilotinib for a total of 146 instances. CHR and MCyR rates were 54% and 37%, respectively in AP, 17% and 39% in BP, and 33% and 50% in Ph+ ALL. Failure to achieve a CHR at the time of achievement of a MCyR was associated with an inferior outcome, similar to that of patients without a MCyR (2-year survival rate, 37% and 35%, respectively). In contrast, patients with MCyR and concomitant CHR had a 77% 2-year survival rate. Twelve of 29 patients with MCyR without concomitant CHR later achieved a CHR; the 2-year survival rate for these patients was 55% compared with 22% for those who never achieved a CHR. These results suggest that achievement of a MCyR without concomitant CHR is associated with poor outcome. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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