Early molecular and cytogenetic response is predictive for long-term progression-free and overall survival in chronic myeloid leukemia (CML)

B. Hanfstein, M. C. Müller, R. Hehlmann, P. Erben, M. Lauseker, A. Fabarius, S. Schnittger, C. Haferlach, G. Göhring, U. Proetel, H. J. Kolb, S. W. Krause, W. K. Hofmann, J. Schubert, H. Einsele, J. Dengler, M. Hänel, C. Falge, L. Kanz, A. NeubauerM. Kneba, F. Stegelmann, M. Pfreundschuh, C. F. Waller, S. Branford, T. P. Hughes, K. Spiekermann, G. M. Baerlocher, M. Pfirrmann, J. Hasford, S. Sauele, A. Hochhaus

Research output: Contribution to journalArticlepeer-review

353 Scopus citations

Abstract

In the face of competing first-line treatment options for CML, early prediction of prognosis on imatinib is desirable to assure favorable survival or otherwise consider the use of a second-generation tyrosine kinase inhibitor (TKI). A total of 1303 newly diagnosed imatinib-treated patients (pts) were investigated to correlate molecular and cytogenetic response at 3 and 6 months with progression-free and overall survival (PFS, OS). The persistence of BCR-ABL transcript levels > 10% according to the international scale (BCR-ABL IS) at 3 months separated a high-risk group (28% of pts; 5-year OS: 87%) from a group with 1-10% BCR-ABL IS (41% of pts; 5-year OS: 94%; P0.012) and from a group with 1% BCR-ABL IS (31% of pts; 5-year OS: 97%; P0.004). Cytogenetics identified high-risk pts by 35% Philadelphia chromosome-positive metaphases (Ph, 27% of pts; 5-year OS: 87%) compared with 35% Ph (73% of pts; 5-year OS: 95%; P0.036). At 6 months, 1% BCR-ABL IS (37% of pts; 5-year OS: 89%) was associated with inferior survival compared with 1% (63% of pts; 5-year OS: 97%; P0.001) and correspondingly 0% Ph (34% of pts; 5-year OS: 91%) compared with 0% Ph (66% of pts; 5-year OS: 97%; P0.015). Treatment optimization is recommended for pts missing these landmarks.

Original languageEnglish
Pages (from-to)2096-2102
Number of pages7
JournalLeukemia
Volume26
Issue number9
DOIs
StatePublished - Sep 2012
Externally publishedYes

Keywords

  • chronic myeloid leukemia
  • cytogenetic response
  • imatinib resistance
  • molecular response
  • prognosis
  • survival

Fingerprint

Dive into the research topics of 'Early molecular and cytogenetic response is predictive for long-term progression-free and overall survival in chronic myeloid leukemia (CML)'. Together they form a unique fingerprint.

Cite this