|
|
Blood, 1 June 2006, Vol. 107, No. 11, pp. 4250-4256.
Prepublished online as a Blood First Edition Paper on February 7, 2006; DOI 10.1182/blood-2005-11-4406.
Previous Article | Next Article 
Submitted November 8, 2005
Accepted January 25, 2006
BCR-ABL mRNA levels at and after the time of a complete cytogenetic response (CCR) predict the duration of CCR in imatinib-treated patients with CML
Richard D Press*, Zac Love, Ashlie A Tronnes, Rui Yang, Thuan Tran, Solange Mongoue-Tchokote, Motomi Mori, Michael J Mauro, Michael W Deininger, and Brian J Druker
Department of Pathology, Oregon Health & Science University, Portland, OR, USA
Biostatistics Shared Resource, Oregon Health & Science University, Portland, OR, USA
Center for Hematologic Malignancies, Cancer Institutes, Oregon Health & Science University, Portland, OR, USA
Center for Hematologic Malignancies, Cancer Institutes, Oregon Health & Science University, Portland, OR, USA; Howard Hughes Medical Institute, Oregon Health & Science University, Portland, OR, USA
* Corresponding author; email: pressr{at}ohsu.edu.
Although most chronic myeloid leukemia (CML) patients treated with imatinib achieve a complete cytogenetic response (CCR), some patients will relapse. To determine the potential of real-time quantitative BCR-ABL RT-PCR to predict the duration of continued CCR, we monitored 85 imatinib-treated patients who achieved a CCR. With a median follow-up of 13 months after CCR (29 months after imatinib; median 6 RQ-PCR assays), 23 patients (27%) had disease progression (predominantly loss of CCR). Compared to the median baseline level of BCR-ABL mRNA, 42% of patients achieved at least a 2-log molecular response at the time of first reaching CCR. Failure to achieve a 2-log response at the time of CCR was an independent predictive marker of subsequent progression-free survival (hazard ratio=5.8; 95%CI, 1.7-20; P=0.005). After CCR, BCR-ABL mRNA levels progressively declined for at least the next 15 months, and 42 patients (49%) ultimately achieved at least a 3-log reduction in BCR-ABL mRNA. Patients failing to achieve this 3-log response, at any time during therapy, had significantly shorter progression-free survival (hazard ratio=8.1; 95%CI, 3.1-22; P< 0.0001). The achievement of either a 2-log molecular response at the time of CCR or a 3-log response anytime thereafter is a significant and independent prognostic marker of subsequent progression-free survival.

CiteULike Connotea Del.icio.us Digg Reddit Technorati What's this?
This article has been cited by other articles:

|
 |

|
 |
 
F. Castagnetti, F. Palandri, M. Amabile, N. Testoni, S. Luatti, S. Soverini, I. Iacobucci, M. Breccia, G. Rege Cambrin, F. Stagno, et al.
Results of high-dose imatinib mesylate in intermediate Sokal risk chronic myeloid leukemia patients in early chronic phase: a phase 2 trial of the GIMEMA CML Working Party
Blood,
April 9, 2009;
113(15):
3428 - 3434.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. Jabbour, J. E. Cortes, and H. M. Kantarjian
Suboptimal Response to or Failure of Imatinib Treatment for Chronic Myeloid Leukemia: What Is the Optimal Strategy?
Mayo Clin. Proc.,
February 1, 2009;
84(2):
161 - 169.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. Laudadio, M. W.N. Deininger, M. J. Mauro, B. J. Druker, and R. D. Press
An Intron-Derived Insertion/Truncation Mutation in the BCR-ABL Kinase Domain in Chronic Myeloid Leukemia Patients Undergoing Kinase Inhibitor Therapy
J. Mol. Diagn.,
March 1, 2008;
10(2):
177 - 180.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H. Kantarjian, C. Schiffer, D. Jones, and J. Cortes
Monitoring the response and course of chronic myeloid leukemia in the modern era of BCR-ABL tyrosine kinase inhibitors: practical advice on the use and interpretation of monitoring methods
Blood,
February 15, 2008;
111(4):
1774 - 1780.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. D. Press, C. Galderisi, R. Yang, C. Rempfer, S. G. Willis, M. J. Mauro, B. J. Druker, and M. W.N. Deininger
A Half-Log Increase in BCR-ABL RNA Predicts a Higher Risk of Relapse in Patients with Chronic Myeloid Leukemia with an Imatinib-Induced Complete Cytogenetic Response
Clin. Cancer Res.,
October 15, 2007;
13(20):
6136 - 6143.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Z. Jobbagy, R. van Atta, K. M. Murphy, J. R. Eshleman, and C. D. Gocke
Evaluation of the Cepheid GeneXpert BCR-ABL Assay
J. Mol. Diagn.,
April 1, 2007;
9(2):
220 - 227.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. P. Kalogianni, V. Bravou, T. K. Christopoulos, P. C. Ioannou, and N. C. Zoumbos
Dry-reagent disposable dipstick test for visual screening of seven leukemia-related chromosomal translocations
Nucleic Acids Res.,
February 28, 2007;
35(4):
e23 - e23.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
W. Ma, R. Tseng, M. Gorre, I. Jilani, M. Keating, H. Kantarjian, J. Cortes, S. O'Brien, F. Giles, and M. Albitar
Plasma RNA as an alternative to cells for monitoring molecular response in patients with chronic myeloid leukemia
Haematologica,
February 1, 2007;
92(2):
170 - 175.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Branford
Chronic Myeloid Leukemia: Molecular Monitoring in Clinical Practice
Hematology,
January 1, 2007;
2007(1):
376 - 383.
[Abstract]
[Full Text]
[PDF]
|
 |
|
|
|