The influence of additive clonal chromosome abnormalities in Ph negative cells on the efficacy of chronic myeloid leukemia
10.3760/cma.j.issn.0578-1426.2019.11.003
- VernacularTitle: 费城染色体阴性细胞出现克隆性染色体异常对慢性髓性白血病疗效影响的临床观察
- Author:
Huifang ZHAO
1
;
Yanli ZHANG
;
Yingling ZU
;
Zhen LI
;
Jian ZHOU
;
Fengkuan YU
;
Jieying HU
;
Xudong WEI
;
Yongping SONG
Author Information
1. Department of Hematology, Henan Cancer Hospital, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
- Publication Type:Journal Article
- Keywords:
Leukemia, myeloid, chronic;
Chromosomal abnormalities;
Philadelphia chromosome-negative cells;
Tyrosine kinase inhibitors;
Treatment outcome
- From:
Chinese Journal of Internal Medicine
2019;58(11):803-807
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the influence of additional clonal chromosome abnormalities in Ph negative cells (CCA/Ph-) on the efficacy of chronic myeloid leukemia (CML) after tyrosine kinase inhibitors (TKI) treatment.
Methods:The clinical data of 28 CML patients with CCA/Ph- treated in Henan Cancer Hospital from July 2014 to December 2017 were analyzed retrospectively. The univariate analysis was carried out by Kaplan-Meier method. Multivariate analysis was done by Cox proportional risk model.
Results:A total of 28 CCA/Ph-patients were recruited including 17 males and 11 females with median age of 42.5 years old. The most common CCA/Ph-were trisomy 8 (60.7%), monosomy 7 (14.3%). 64.3% CCA/Ph-were transient and 35.7% recurrent (more than 2 times). Cytopenia in two or three lineages of peripheral blood was seen in 42.9% patients. As to the efficacy, 89.3% patients achieved major cytogenetic response (MCyR), 25% with major molecular response (MMR). The median follow-up time was 26.5 months. Treatment failure (TF) of TKI occurred in 32.1% patients with median duration of response 8 (1-41) months. Univariate analysis showed that TF rate was significantly correlated with the frequency of CCA/Ph-and cytopenia (all P<0.05). The MMR rate was also significantly correlated with cytopenia (P<0.05). Cytopenia of two lineages or pancytopenia was an independent risk factor related to MMR rate (RR=3.868, 95%CI 1.216-12.298, P=0.022) .
Conclusions:Cytopenia in CCA/Ph-appears to be an independent risk factor of MMR in CML patients with TKI treatment. The recurrent CCA/Ph-may link to higher treatment failure rate. Drug withdrawal or alternative strategy should be considered according to response and the ABL kinase mutations.
