Adenocarcinoma ; complications ; drug therapy ; metabolism ; Aged ; Antineoplastic Agents ; therapeutic use ; Fusion Proteins, bcr-abl ; metabolism ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; diagnosis ; etiology ; metabolism ; Male ; Organoplatinum Compounds ; therapeutic use ; Stomach Neoplasms ; drug therapy ; metabolism

OBJECTIVETo understand the prognostic value of early monitoring BCR-ABL transcripts in patients with chronic myeloid leukemia (CML) after treatment with imatinib, and to provide the information for early assessment of prognosis and treatment options.

METHODSThe clinical data of 251 patients with CML in chronic phase (CML-CP) who received imatinib as first-line therapy were retrospectively analyzed, the progression-free survival (PFS)and overall survival (OS) between different BCR-ABL transcriptional level at 3 and 6 month after imatinib treatment were compared. Meanwhile, Chi-square test and logistic regression were used to analyze the risk factors for disease progression.

RESULTSAt 3 months after imatinib treatment BCR-ABL transcriptional levels>10%, >1%-≤ 10% and ≤ 1% were found in 92, 94 and 64 patients, their PFS were 53.3%, 71.3% and 86.2%, respectively. The results showed that the PFS of patients with low BCR-ABL transcriptional levels was significantly superior to that with high BCR-ABL transcriptional levels for CML at 3 months treatment (P<0.05). The OS of three group did not reach statistical significance (92.4% vs 96.8% vs 93.8%, P> 0.05). When 182 patients received imatinib treatment at 6 months, 22 patients with BCR-ABL transcriptional levels>10%, 50>1% -≤ 10% and 110 ≤ 1%, their PFS were 27.3% vs 66.0% vs 82.7% (P<0.05), the OS of three groups were 86.4% vs 94.0% vs 100%. There were significant differences among the three groups (P<0.05). Logistic regression confirmed that the level of BCR-ABL transcriptional level at 3 and 6 months after imatinib treatment was independent factor to influence the progress of disease.

CONCLUSIONIt is important for the prognosis evaluation of CML patients to monitor BCR-ABL transcriptional level at 3 and 6 months after imatinib treatment.

Antineoplastic Agents ; therapeutic use ; Disease-Free Survival ; Fusion Proteins, bcr-abl ; metabolism ; Humans ; Imatinib Mesylate ; therapeutic use ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; diagnosis ; drug therapy ; Prognosis ; Retrospective Studies ; Risk Factors

No abstract available.
Aged ; Antineoplastic Agents/therapeutic use ; Bone Marrow/pathology ; Fusion Proteins, bcr-abl/genetics/metabolism ; Humans ; Imatinib Mesylate/therapeutic use ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications/*diagnosis/drug therapy ; Leukocyte Count ; Male ; Multiple Myeloma/complications/*diagnosis/drug therapy ; Platelet Count ; Polymerase Chain Reaction ; Thrombocytosis/etiology

No abstract available.
Adolescent ; Antineoplastic Agents/therapeutic use ; Benzamides/therapeutic use ; Chromosome Deletion ; Chromosomes, Human, Pair 7 ; Drug Resistance, Neoplasm ; Fusion Proteins, bcr-abl/genetics/*metabolism ; Humans ; Immunophenotyping ; Karyotyping ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/*diagnosis/drug therapy/metabolism ; Male ; Piperazines/therapeutic use ; Pyrimidines/therapeutic use ; Real-Time Polymerase Chain Reaction

No abstract available.
Adult ; Antineoplastic Agents/therapeutic use ; *Chromosome Deletion ; *Chromosomes, Human, Pair 9 ; Cytogenetic Analysis ; DNA Mutational Analysis ; Fusion Proteins, bcr-abl/*antagonists & inhibitors/genetics/metabolism ; Gene Expression Regulation ; Humans ; Incidental Findings ; Klinefelter Syndrome/complications/diagnosis/*genetics ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications/diagnosis/*drug therapy/enzymology/genetics ; Male ; Molecular Targeted Therapy ; Protein Kinase Inhibitors/*therapeutic use ; Remission Induction ; Time Factors ; Treatment Outcome

No abstract available.
Antineoplastic Agents/*therapeutic use ; Benzamides/*therapeutic use ; Central Nervous System Neoplasms/*diagnosis ; Fusion Proteins, bcr-abl/genetics ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/*drug therapy ; Leukocytes/metabolism/pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Piperazines/*therapeutic use ; Pyrimidines/*therapeutic use

INTRODUCTIONThe prognosis of patients with chronic myeloid leukaemia (CML) has improved since the introduction of imatinib. However, patients who do not achieve complete cytogenetic response (CCyR) and major molecular response (MMR) have poorer prognosis. Recent clinical trials have demonstrated that early and deeper cytogenetic and molecular responses predict a better long-term outcome. This study aimed to analyse the relationship between early molecular response and clinical outcome in a real-life setting.

METHODSThis retrospective study included all patients with CML, in chronic or accelerated phase, who were treated with imatinib at University of Malaya Medical Centre, Malaysia.

RESULTSA total of 70 patients were analysed. The median follow-up duration was 74 months, and the cumulative percentages of patients with CCyR and MMR were 80.0% and 65.7%, respectively. Overall survival (OS) and event-free survival (EFS) at ten years were 94.3% and 92.9%, respectively. Patients who achieved CCyR and MMR had significantly better OS and EFS than those who did not. At six months, patients who had a BCR-ABL level ≤ 10% had significantly better OS and EFS than those who had a BCR-ABL level > 10%. The target milestone of CCyR at 12 months and MMR at 18 months showed no survival advantage in our patients.

CONCLUSIONOur data showed that imatinib is still useful as first-line therapy. However, vigilant monitoring of patients who have a BCR-ABL level > 10% at six months of treatment should be implemented so that prompt action can be taken to provide the best outcome for these patients.

Academic Medical Centers ; Adult ; Antineoplastic Agents ; therapeutic use ; Cytogenetics ; Disease-Free Survival ; Female ; Follow-Up Studies ; Fusion Proteins, bcr-abl ; metabolism ; Humans ; Imatinib Mesylate ; therapeutic use ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; diagnosis ; drug therapy ; genetics ; Malaysia ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Universities