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Effects of Deeper Molecular Responses on Outcomes in Chronic Myeloid Leukemia Patients in Chronic Phase Treated With Imatinib Mesylate

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dc.contributor.authorATAGÜNDÜZ, IŞIK
dc.contributor.authorsAtagunduz, Isik Kaygusuz; Toptas, Tayfur; Deniz, Rabia; Kara, Osman; Eser, All; Sezgin, Aslihan; Ozgumus, Toluy; Gecgel, Fatma; Tuglularl, Tulin Firatli
dc.date.accessioned2022-03-12T20:31:07Z
dc.date.available2022-03-12T20:31:07Z
dc.date.issued2017
dc.description.abstractThe significance of molecular response depth is not well defined in patients with chronic phase chronic myeloid leukemia (CP-CML) under imatinib treatment. We retrospectively evaluated clinical records of 178 patients with CP-CML. Eighty-eight patients achieved complete molecular response during long term follow-up. Our results implicate that deeper molecular response is associated with improvement in disease outcome and a slight prolongation in progression-free survival. Background: The prognostic significance of complete cytogenetic response (CCyR) is well defined in patients with chronic phase chronic myeloid leukemia treated with imatinib as first-line therapy. However, the effect on outcomes of obtaining molecular response itself and the depth of it is not clear. In this study we aimed to determine the frequency of complete molecular response (CMR) during long-term follow-up and the clinical significance of CMR on patient outcomes and survival. Patients and Methods: We retrospectively evaluated the files of 178 chronic phase chronic myeloid leukemia patients using imatinib therapy. Forty-seven patients with missing data were excluded from the study and the assessment was done in 131 patients. CiviR was defined as undetectable BCR-ABL transcripts using real-time quantitative polymerase chain reaction with a sensitivity level of >= 10(4) in 2 consecutive analyses at least 3 months apart. Cytogenetic and molecular monitoring during treatment was performed according to the European LeukemiaNet recommendations criteria. Our primary objective was to analyze the association of deeper molecular response with differences in progression-free survival (PFS). Results: Eighty-eight patients (67%) achieved CMR at any time in a median of 65 months of follow-up. The rate of CMR was higher in patients who achieved CCyR at 12 months and major molecular response (MMR) at 18 months. Fewer events occurred in the CMR group than the MMR group (26.1% vs. 50.0%). Overall survival was not different in both groups. CMR was associated with longer PFS with borderline significance. Conclusion: Prolonged imatinib therapy helps to achieve a deeper molecular response in the long-term. Achieving deeper molecular response at any time positively affects maintaining the cytogenetic and molecular responses, and decreases the transformation to accelerated and/or blastic phase. The slight prolongation in PFS did not reach statistical significance.
dc.identifier.doi10.1016/j.clml.2016.09.006
dc.identifier.eissn2152-2669
dc.identifier.issn2152-2650
dc.identifier.pubmed28082113
dc.identifier.urihttps://hdl.handle.net/11424/234252
dc.identifier.wosWOS:000395846000008
dc.language.isoeng
dc.publisherCIG MEDIA GROUP, LP
dc.relation.ispartofCLINICAL LYMPHOMA MYELOMA & LEUKEMIA
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectBCR-ABL
dc.subjectDisease outcome
dc.subjectMolecular monitorization
dc.subjectProgression-free survival
dc.subjectTyrosine kinase inhibitors
dc.subjectDIAGNOSED CHRONIC-PHASE
dc.subjectCHRONIC MYELOGENOUS LEUKEMIA
dc.subjectALPHA PLUS CYTARABINE
dc.subjectFOLLOW-UP
dc.subject800 MG
dc.subjectINTERFERON
dc.subjectNILOTINIB
dc.subjectPREDICTS
dc.subjectTIME
dc.subjectDASATINIB
dc.titleEffects of Deeper Molecular Responses on Outcomes in Chronic Myeloid Leukemia Patients in Chronic Phase Treated With Imatinib Mesylate
dc.typearticle
dspace.entity.typePublication
local.avesis.idf193922a-de36-4e87-8806-98524940f96e
local.import.packageSS17
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.numberofpages6
local.journal.quartileQ3
oaire.citation.endPage125
oaire.citation.issue2
oaire.citation.startPage120
oaire.citation.titleCLINICAL LYMPHOMA MYELOMA & LEUKEMIA
oaire.citation.volume17
relation.isAuthorOfPublication689dc227-5bcc-4ccf-9bb3-b1eb433b5a45
relation.isAuthorOfPublication.latestForDiscovery689dc227-5bcc-4ccf-9bb3-b1eb433b5a45

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