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Blood, 15 January 2004, Vol. 103, No. 2, pp. 451-455. Prepublished online as a Blood First Edition Paper on September 25, 2003; DOI 10.1182/blood-2003-02-0371. This Article Full Text Full Text (PDF) All Versions of this Article: 2003-02-0371v1 103/2/451    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 O'Dwyer, M. E. Articles by Druker, B. J. Search for Related Content PubMed PubMed Citation Articles by O'Dwyer, M. E. Articles by Druker, B. J. Related Collections Neoplasia Oncogenes and Tumor Suppressors Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Clonal evolution and lack of cytogenetic response are adverse prognostic factors for hematologic relapse of chronic phase CML patients treated with imatinib mesylate Michael E. O'Dwyer, Michael J. Mauro, Carolyn Blasdel, Melanie Farnsworth, Gwen Kurilik, Yi-Ching Hsieh, Motomi Mori, and Brian J. Druker From the Leukemia Center and Cancer Institute, Oregon Health and Science University, Portland. We followed 141 patients treated with imatinib mesylate (> 300 mg) for chronicphase chronic myelogenous leukemia (CML) following failure of treatment with interferon. During 12 months from the start of imatinib mesylate treatment, 96.5% achieved a complete hematologic response, 47.0% achieved a major cytogenetic response, and 32.4% achieved a complete cytogenetic response. The proportion of patients with hematologic relapse was 10.9% at 12 months and 14.6% at 18 months. In a univariate Cox regression analysis, the only pretreatment characteristics that correlated with an increased risk of hematologic relapse were hemoglobin level less than 120 g/L (12 g/dL) (P = .02), increased bands in the peripheral blood (P = .01), and clonal evolution (P < .0001). In a multivariate analysis, an elevated platelet count (P = .03) and clonal evolution (P < .0001) were the only significant factors for hematologic relapse. During treatment, the absence of a major cytogenetic response within the first 6 months also significantly correlated with relapse (P = .03). Notably, patients failing to achieve a major cytogenetic response by 6 months had a significantly higher rate of hematologic relapse (27%) compared with those who achieved a major cytogenetic response by 6 months (3%), and patients with clonal evolution had a significantly higher risk of hematologic relapse (50%) than those without clonal evolution (9%). CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. Baccarani, F. Pane, and G. Saglio Monitoring treatment of chronic myeloid leukemia Haematologica, February 1, 2008; 93(2): 161 - 169. [Full Text] [PDF] M. Brave, V. Goodman, E. Kaminskas, A. Farrell, W. Timmer, S. Pope, R. Harapanhalli, H. Saber, D. Morse, J. Bullock, et al. Sprycel for Chronic Myeloid Leukemia and Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia Resistant to or Intolerant of Imatinib Mesylate Clin. Cancer Res., January 15, 2008; 14(2): 352 - 359. 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Proc., May 1, 2005; 80(5): 681 - 698. [Abstract] [PDF] H. M. Kantarjian, J. E. Cortes, S. O'Brien, R. Luthra, F. Giles, S. Verstovsek, S. Faderl, D. Thomas, G. Garcia-Manero, M. B. Rios, et al. Long-term survival benefit and improved complete cytogenetic and molecular response rates with imatinib mesylate in Philadelphia chromosome-positive chronic-phase chronic myeloid leukemia after failure of interferon-{alpha} Blood, October 1, 2004; 104(7): 1979 - 1988. [Abstract] [Full Text] [PDF]

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