Curative Efficacy of First Generation TKI in the Treatment of CML-CP Combined with vPh and Analysis of Its Genetic Characteristics.
10.19746/j.cnki.issn.1009-2137.2020.04.013
- Author:
Lin TAN
1
;
Yu XIE
1
;
Jian YANG
1
;
Lin LIU
2
Author Information
1. Department of Hematology, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China.
2. Department of Hematology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China,E-mail: kmliulin1210@163.com.
- Publication Type:Journal Article
- MeSH:
Fusion Proteins, bcr-abl;
Humans;
Imatinib Mesylate;
Karyotyping;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive;
Protein Kinase Inhibitors;
Treatment Outcome
- From:
Journal of Experimental Hematology
2020;28(4):1162-1166
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the curative efficacy of first generation TKI in the treatment of CML-CP combined with vPh and genetic characteristics.
METHODS:60 patients with CML-CP combined with vPh from January 2010 to May 2017 in the First Affiliated Hospital of Kunming Medical University were chosen as CML-CP-vPh group, and 107 patients with CML-CP combined with typical Ph chromosome at the same time were chosen as control group. The patients in two groups were treated with imatinib; The curative efficacy, karyotype and FISH signal type were compared between 2 groups, and the factors influencing long-term survival of patients were analyzed by Cox risk model.
RESULTS:There was no significant difference in the demographic and hematological baseline data between 2 groups (P＞0.05), and there was no significant difference in the incidence of drug-resistance between 2 groups (P＞0.05). The incidence of primary drug-resistance and primary hematological drug-resistance in the CML-CP-vPh group were significantly higher than that in control group (P＜0.05). There was no significant difference in the accumulative CCyR rate, accumulative MMR rate, OS and EFS between 2 groups (P＞0.05). Multivariate Cox model analysis showed that vPh not correlated with OS and EFS of patients with CML-CP (P＞0.05). The factors influencing OS in CML-vPh patients included high risk of Sokal scores, peripheral blood basophils proportion ≥10%, BCR-ABL in 3 months after treatment＜10%, achieviag CCyR in 6 months after treatment and achieviag MMR in 12 months after treatment (P＜0.05). The factors influencing EFS included BCR-ABL＜10% in 3 months after treatment and achieving MMR in 12 months after treatment (P＜0.05). The regions with high frequency of heterotopic involvement included 12q1, 12q2 [9 cases (15.00%)] and 1p3 [8 cases (13.33%)]. The percentage of 2G2R1Y, 1G1R2F, 1G2R1Y, 2G1R1Y and 1G1R1Y in FISH signal types were 73.33%, 10.00%, 1.67%, 1.67% and 1.67% respectively.
CONCLUSION:Patients with CML-CP combined with vPh possess higher primary drug-resistance rate and primary hematological drug-resistance rate for the first generation TKI, while second-generation TKI can efficiently improve long-term survival, its efficacy is similar to efficacy for patients with typical Ph chromosomes. CML-CP combined with vPh does not display special demographic and hematological characteristics. The main involved regions of heterotopic variants include 12q1, 12q2 and 1p3, while 2G2R1Y type is the most common type of FISH signal.
