1.Impact of timely BCR-ABL1 monitoring before allogeneic stem cell transplantation among patients with BCR-ABL1-positive B-acute lymphoblastic leukemia
Siew Lian CHONG ; Asral Wirda AHMAD ASNAWI ; Tze Shin LEONG ; Jenq Tzong TAN ; Kian Boon LAW ; Siong Leng HON ; Rui Jeat FANN ; Sen Mui TAN
Blood Research 2021;56(3):175-183
Background:
With the emergence of tyrosine kinase inhibitors and the incorporation of stringent measurable residual disease (MRD) monitoring, risk stratification for BCR-ABL1-positive acute lymphoblastic leukemia (ALL) patients has changed significantly. However, whether this monitoring can replace conventional risk factors in determining whether patients need allogeneic stem cell transplantation is still unclear. This study aimed to determine the impact of BCR-ABL1 monitoring on the outcome of patients with BCR-ABL1-positive ALL after allogeneic stem cell transplantation.
Methods:
We retrospectively analyzed the survival outcome of patients with BCR-ABL1-positive ALL based on the quantification of BCR-ABL1 at 3 timepoints: the end of induction (timepoint 1), post-consolidation week 16 (timepoint 2), and the end of treatment for patients who were either transplant-eligible or non-transplant eligible (timepoint 3).
Results:
From 2006 to 2018, a total of 96 patients newly diagnosed with BCR-ABL1-positive ALL were treated with chemotherapy and tyrosine kinase inhibitors. Thirty-eight (41.3%) patients achieved complete remission, and 33 patients underwent allogeneic stem cell transplantation. Our data showed that pre-transplant MRD monitoring by real-time quantitative polymerase chain reaction had the highest correlation with survival in patients with BCR-ABL1-positive ALL, especially for those who underwent allogeneic stem cell transplantation.
Conclusion
Patients without MRD pre-transplantation had superior survival compared with those who had MRD, and they had excellent long-term outcomes after allogeneic stem cell transplantation.
2.Bone health among older persons in medical clinic: A clinical audit
Cheng Lay Teh ; Seow Lin Chuah ; Hong Khoh Lee ; Sharifah Aishah binti Wan Mohd Akbar ; Tze Shin Leong ; Florence Hui Sieng Tan ; Bik Kui Lau
The Medical Journal of Malaysia 2020;75(2):191-193
Osteoporosis is commonly underdiagnosed and
undertreated. We performed a clinical audit to assess the
risk factors and clinical care for osteoporosis among older
persons who attended medical clinic during a 4-week period
in August 2013. There was a total of 128 patients with a mean
age of 73.1±5.8 years, and 20.3%. had a history of fall.
Fracture Risk Assessment Tool (FRAX) scores assessment
showed 14.2% and 68.8% had a 10-year risk of major
osteoporotic and hip fractures respectively. Only 6.3%
underwent Dual-energy X-ray absorptiometry (DXA) and
73.4% did not receive any preventive treatment for
osteoporosis. Older persons attending medical clinic at high
risk of osteoporosis fractures did not receive appropriate
screening and treatment. There is a need to improve the
suboptimal care for bone health among older persons.
3.Impact of timely BCR-ABL1 monitoring before allogeneic stem cell transplantation among patients with BCR-ABL1-positive B-acute lymphoblastic leukemia
Siew Lian CHONG ; Asral Wirda AHMAD ASNAWI ; Tze Shin LEONG ; Jenq Tzong TAN ; Kian Boon LAW ; Siong Leng HON ; Rui Jeat FANN ; Sen Mui TAN
Blood Research 2021;56(3):175-183
Background:
With the emergence of tyrosine kinase inhibitors and the incorporation of stringent measurable residual disease (MRD) monitoring, risk stratification for BCR-ABL1-positive acute lymphoblastic leukemia (ALL) patients has changed significantly. However, whether this monitoring can replace conventional risk factors in determining whether patients need allogeneic stem cell transplantation is still unclear. This study aimed to determine the impact of BCR-ABL1 monitoring on the outcome of patients with BCR-ABL1-positive ALL after allogeneic stem cell transplantation.
Methods:
We retrospectively analyzed the survival outcome of patients with BCR-ABL1-positive ALL based on the quantification of BCR-ABL1 at 3 timepoints: the end of induction (timepoint 1), post-consolidation week 16 (timepoint 2), and the end of treatment for patients who were either transplant-eligible or non-transplant eligible (timepoint 3).
Results:
From 2006 to 2018, a total of 96 patients newly diagnosed with BCR-ABL1-positive ALL were treated with chemotherapy and tyrosine kinase inhibitors. Thirty-eight (41.3%) patients achieved complete remission, and 33 patients underwent allogeneic stem cell transplantation. Our data showed that pre-transplant MRD monitoring by real-time quantitative polymerase chain reaction had the highest correlation with survival in patients with BCR-ABL1-positive ALL, especially for those who underwent allogeneic stem cell transplantation.
Conclusion
Patients without MRD pre-transplantation had superior survival compared with those who had MRD, and they had excellent long-term outcomes after allogeneic stem cell transplantation.