SEARCH:   Advanced

Prepublished online as a Blood First Edition Paper on September 25, 2003; DOI 10.1182/blood-2003-02-0371. This Article 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 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 Social Bookmarking                   What's this? Submitted February 10, 2003 Accepted September 3, 2003 Clonal evolution and lack of cytogenetic response are adverse prognostic factors for hematologic relapse of chronic phase CML patients treated with Imatinib mesylate (STI571) Michael E O'Dwyer*, Michael J Mauro, Carolyn Blasdel, Melanie Farnsworth, Gwen Kurilik, Yi-Ching Hsieh, Motomi Mori, and Brian J Druker Leukemia Center, Oregon Health and Science University, Portland, OR, USA Cancer Institute, Oregon Health and Science University, Portland, OR, USA * Corresponding author; email: michael.odwyer{at}whb.ie. We followed 141 patients treated with imatinib mesylate (>300 mg) for chronic phase CML following interferon failure. During 12 months from the start of imatinib treatment, 96.5% achieved a complete hematological response and 47.0% achieved a major cytogenetic response with 32.4% a complete cytogenetic response. The proportion of patients with hematological relapse was 10.9% at 12 months and 14.6% at 18 months. In a univariate Cox regression analysis, the only pre-treatment characteristics that correlated with an increased risk of hematological relapse were hemoglobin < 12g/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=0.03), and clonal evolution (p < .0001) were the only significant factors for hematological relapse. During treatment, the absence of a major cytogenetic response within the first six 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 hematological relapse (27%) compared to those who achieved a major cytogenetic response by 6 months (3%), and patients with clonal evolution had a significantly higher risk of hematological 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. [Abstract] [Full Text] [PDF] D. P. Steensma and R. E. Richard Myeloproliferative disorders ASH Self-Assessment Program, January 1, 2007; 2007(1): 172 - 227. [Full Text] [PDF] M. Baccarani, G. Saglio, J. Goldman, A. Hochhaus, B. Simonsson, F. Appelbaum, J. Apperley, F. Cervantes, J. Cortes, M. Deininger, et al. Evolving concepts in the management of chronic myeloid leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet Blood, September 15, 2006; 108(6): 1809 - 1820. [Abstract] [Full Text] [PDF] R. D. Press, Z. Love, A. A. Tronnes, R. Yang, T. Tran, S. Mongoue-Tchokote, M. Mori, M. J. Mauro, M. W. Deininger, and B. J. Druker BCR-ABL mRNA levels at and after the time of a complete cytogenetic response (CCR) predict the duration of CCR in imatinib mesylate-treated patients with CML Blood, June 1, 2006; 107(11): 4250 - 4256. [Abstract] [Full Text] [PDF] I. Iacobucci, G. Rosti, M. Amabile, A. Poerio, S. Soverini, D. Cilloni, N. Testoni, E. Abruzzese, E. Montefusco, E. Ottaviani, et al. Comparison Between Patients With Philadelphia-Positive Chronic Phase Chronic Myeloid Leukemia Who Obtained a Complete Cytogenetic Response Within 1 Year of Imatinib Therapy and Those Who Achieved Such a Response After 12 Months of Treatment J. Clin. Oncol., January 20, 2006; 24(3): 454 - 459. [Abstract] [Full Text] [PDF] M. Van Glabbeke, J. Verweij, P. G. Casali, A. Le Cesne, P. Hohenberger, I. Ray-Coquard, M. Schlemmer, A. T. van Oosterom, D. Goldstein, R. Sciot, et al. Initial and Late Resistance to Imatinib in Advanced Gastrointestinal Stromal Tumors Are Predicted by Different Prognostic Factors: A European Organisation for Research and Treatment of Cancer-Italian Sarcoma Group-Australasian Gastrointestinal Trials Group Study J. Clin. Oncol., August 20, 2005; 23(24): 5795 - 5804. [Abstract] [Full Text] [PDF] D. P. Steensma and A. F. List Genetic Testing in the Myelodysplastic Syndromes: Molecular Insights Into Hematologic Diversity Mayo Clin. 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]

	Copyright © 2003 by American Society of Hematology         Online ISSN: 1528-0020