Evaluation of 5‐year imatinib treatment of 458 patients with CP‐CML in routine clinical practice and prognostic impact of different BCR‐ABL cutoff levels

Medientyp: E-Artikel
Titel: Evaluation of 5‐year imatinib treatment of 458 patients with CP‐CML in routine clinical practice and prognostic impact of different BCR‐ABL cutoff levels
Beteiligte: Klamová, Hana; Poláková, Kateřina Machová; Mužík, Jan; Ráčil, Zdeněk; Žáčková, Daniela; Steinerová, Kateřina; Karas, Michal; Faber, Edgar; Demečková, Eva; Michalovičová‐Sninská, Zuzana; Voglová, Jaroslava; Demitrovičová, Ľudmila; Mikušková, Eva; Tóthová, Elena; Chudej, Juraj; Markuljak, Imrich; Cmunt, Eduard; Moravcová, Jana; Dvořáková, Dana; Michalová, Kyra; Jarošová, Marie; Šťastná, Markéta Marková; Cetkovský, Petr; DuŠek, Ladislav; [...]
Erschienen: Wiley, 2013
Erschienen in: Cancer Medicine
Sprache: Englisch
DOI: 10.1002/cam4.59
ISSN: 2045-7634
Schlagwörter: Cancer Research ; Radiology, Nuclear Medicine and imaging ; Oncology
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Beschreibung: <jats:title>Abstract</jats:title><jats:p>We evaluated responses to the treatment and long‐term outcomes of chronic myeloid leukemia patients treated with imatinib as first‐line treatment in routine clinical setting from two countries with centralized tyrosine kinase inhibitors (<jats:styled-content style="fixed-case">TKI</jats:styled-content>s) treatment. We assessed prognostic significance of European LeukemiaNet (<jats:styled-content style="fixed-case">ELN</jats:styled-content>) 2006‐ and 2009‐defined responses and the prognostic value of molecular responses at defined time points on 5‐year survivals. Among the cumulative rates of incidence of hematologic, cytogenetic, and molecular responses and all important survival parameters, we evaluated the prognostic significance of different <jats:styled-content style="fixed-case">BCR</jats:styled-content>‐<jats:styled-content style="fixed-case">ABL</jats:styled-content> transcript‐level ratios (≤1%; >1%–≤10%; >10%) at 3, 6, 12, and 18 months (<jats:italic>n</jats:italic> = 199). The <jats:styled-content style="fixed-case">ELN</jats:styled-content> optimal response criteria and their predictive role were significantly beneficial for event‐free survival at all given time points. We found significant improvement in survivals of patients with <jats:styled-content style="fixed-case">BCR</jats:styled-content>‐<jats:styled-content style="fixed-case">ABL</jats:styled-content> lower than 10% in the 6th and 12th months. Significantly better outcome was found in patients who achieved major molecular response (<jats:styled-content style="fixed-case">MMR</jats:styled-content>) in the 12th month. The cumulative incidences of complete cytogenetic response (<jats:styled-content style="fixed-case">CCyR</jats:styled-content>) and <jats:styled-content style="fixed-case">MMR</jats:styled-content> were significantly associated with the molecular response in the 3rd month. The <jats:styled-content style="fixed-case">ELN</jats:styled-content> response criteria and their predictive role were helpful at given time points; however, the 2009 definition did not significantly alter the prognostic accuracy compared with that of the 2006 definition. The significant value was observed for cytogenetic responses at the 6th and 12th month. Moreover, progression‐free and event‐free survivals were improved with <jats:styled-content style="fixed-case">MMR</jats:styled-content> at the 12th month.</jats:p>
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