1.Sumary of the duration of the phase transfer of chronic myeloid leukemia
Journal of Vietnamese Medicine 2001;257(3):1-4
A restrospective study carried out on 309 patients with chronic myelogenous leukemia treated from 1990 to 10/2000 showed that; -88 cases (28.3%) converted to the blast crisis. - 89.77% of these cases developed acute myeloblastic leukemia (AML) and 9.09% developed ALL.-The percentage of male and female were 55.68% and 44.31% - 45.45% of these converted cases occurred in the age group of 30-50. The youngest age was 10 months and the oldest age was : 72 years old. Mean of duration of the chronic phase was 2.5 years.
Leukemia, Myeloid, Chronic
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Leukemia, Myeloid, Chronic-Phase
3.Efficacy and safety of generic imatinib mesylate capsules produced in China for newly diagnosed chronic myeloid leukemia in chronic phase patients.
Juan CHEN ; Li ZHOU ; Shenghong DU ; Hongying LU ; Shujun SUN ; Junmin LI ; Weili ZHAO ; Zhixiang SHEN
Chinese Journal of Hematology 2015;36(3):235-237
4.Comparative study of molecular response of first-line and second-line nilotinib in patients with chronic-phase chronic myelogenous leukemia.
Hui XU ; Ping WANG ; Rong Jun MA ; Jian Min GUO ; Ping Chong LEI ; Yu Zhu ZANG ; Tong Bao WANG ; Zhong Wen LIU ; Jing YANG ; Yin ZHANG ; Zun Min ZHU
Chinese Journal of Hematology 2019;40(6):522-525
5.Prognostic significance of early molecular response after second-line treatment with dasatinib of chronic myeloid leukemia patients.
Yi Lin CHEN ; Li MENG ; Guo Lin YUAN ; Zhuang Zhi YANG ; Zhi Ping HUANG ; You Shan ZHANG ; Zhe ZHAO ; Chu Cheng WANG ; Ying BAO ; Hang XIANG ; Hua YIN ; Li Feng CHEN ; Ying Yuan XIONG ; Long WANG ; Wei Ming LI
Chinese Journal of Hematology 2019;40(7):608-611
6.Nonmyeloablative peripheral blood stem cell transplantation for chronic myeloid leukemia in chronic and accelerated phases.
Jia-Hua DING ; Yan MA ; Bao-An CHEN ; Gang ZHAO ; Jun WANG ; Yun-Yu SUN ; Jian CHENG ; Ai-Ling SU ; Wei-Ming DONG ; Yan ZHANG
Journal of Experimental Hematology 2008;16(2):373-376
The aim of this study was to investigate the effect of nonmyeloablative peripheral blood stem cell transplantation in treatment of chronic myeloid leukemia in chronic phase (CML-CP) and accelerated phase (CML-AP). 24 patients with CML including 16 in CML-CP and 8 in CML-AP were treated with nonmyeloablative conditioning regimen for peripheral blood stem cell transplantation (PBHSCT). The conditioning regimen included fludarabine (30 mg/m(2)x6 d), busulphan [4 mg/(kg.d)x2 d] and CTX [350 mg/(m2.d)x2 d] combined with or without Ara-C. The donors were HLA-identical (n=20) and 5/6 antigen-matched (n=4). The dynamic observation of hematopoietic recovery in all patients was carried out. The results indicated that all the patients were successfully engrafted. The mean time for increase of the number of neutrophils to more than 0.5x10(9)/L and platelet more than 20x10(9)/L were 13 days and 11.5 days respectively. Out of 12 patients, 9 patients showed complete donor chimerism and 3 patients showed mixed chimerism at 30 days after transplantation. At 180 days after transplantation, 18 survival patients showed complete donor chimerism. 18 patients remained alive after a median follow-up length of 24 months (4-48 months). 2 cases died of severe acute GVHD and 1 case died of chronic GVHD, 2 cases died of interstitial pneumonia and 1 case died of relapsed. In conclusions, nonmyeloablative peripheral blood stem cell transplantation is an effective therapeutic method for CML patients in chronic phase and accelerated phase.
Adult
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Female
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Graft vs Host Disease
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prevention & control
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Humans
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Leukemia, Myeloid, Accelerated Phase
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therapy
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Leukemia, Myeloid, Chronic-Phase
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therapy
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Male
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Middle Aged
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Peripheral Blood Stem Cell Transplantation
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methods
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Transplantation Conditioning
7.Report of 8 cases of bcr-abl gene positive thrombocytosis and review of the literature.
Feng-ru LIN ; Yan WANG ; Jing CHEN
Chinese Journal of Hematology 2004;25(9):528-531
OBJECTIVETo analyse the features of 8 cases of Bcr(+) thrombocytosis.
METHODSThe clinical and hematological features and therapeutic outcomes were studied retrospectively in 8 Bcr(+) thrombocytosis and compared with essential thrombocytosis (ET) and chronic myeloid leukemia-chronic phase thrombocytosis (CML-CP-T). BCR-ABL fusion gene was detected with PCR.
RESULTS(1) Except for the presence of BCR-ABL fusion gene, there was no significant difference in clinical and hematological features and therapeutic outcomes between thrombocytosis with or without BCR-ABL. (2) The Bcr(+) thrombocytosis differed from CML-CP-T in the following aspects: female predominance, milder or no splenomegaly, peripheral leukocytes count < 40 x 10(9)/L, less or no basophilia and fewer immature granulocytes in peripheral blood, bone marrow granulocytic and/or megakaryocytic lineage hyperplasia, normal or increased neutrophil alkaline phosphatase score and less blastic transformation.
CONCLUSIONBcr(+) thrombocytosis may be considered as a new member of chronic myeloproliferative diseases, a variant of essential thrombocythemia.
Adult ; Aged ; Female ; Fusion Proteins, bcr-abl ; genetics ; Humans ; Leukemia, Myeloid, Chronic-Phase ; genetics ; pathology ; therapy ; Male ; Middle Aged ; Prognosis ; Thrombocytosis ; genetics ; pathology ; therapy ; Young Adult
8.The molecular-cytogenetic characterization and tyrosine kinase inhibitors efficacy in newly diagnosed chronic phase CML patients with variant Philadelphia chromosomes.
Juan Juan ZHAO ; Yan Li ZHANG ; Sheng Jie ZHANG ; Jian ZHOU ; Feng Kuan YU ; Ying Ling ZU ; Hui Fang ZHAO ; Zhen LI ; Yong Ping SONG
Chinese Journal of Hematology 2018;39(3):212-218
Objective: To investigate the molecular-cytogenetic characterization and impact on tyrosine kinase inhibitors (TKIs) therapy in chronic phase of chronic myeloid leukemia (CML-CP) patients with variant Ph chromosome (vPh). Methods: The clinical data of 32 patients with vPh chromosomes were collected and compared with 703 patients with typical Ph chromosome in newly diagnosed CML-CP who were on first-line imatinib (IM) and with BCR-ABL transcript of P210. Results: There was no significant difference in demographic and hematological characteristics between vPh and classic Ph patients. 3(9.4%) of the 32 vPh cases were simple variant translocations. Among the remaining 29 cases with complex variant translocations, 28 cases (87.5%) involved 3 chromosomes, and only 1 (3.1%) involved 4 chromosomes. Except for 8, 15, 18, X, and Y chromosomes, the other chromosomes were involved. The frequency of chromosome 12q(15.5%) and 1p (12.1%) were higher involved. The most common FISH signal pattern was 2G2R1Y (74.1%), followed by 1G1R2F (14.8%), 2G1R1Y (3.7%), 1G2R1Y (3.7%), 1G1R1Y (3.7%). The comparison of complete cytogenetic response (CCyR) (P=0.269), major molecular response (MMR) (P=0.391) were carried out between simple and complex mechanisms, without difference. Compared with the classic Ph, the patients with vPh had higher IM primary resistance rate (χ2=3.978, P=0.046), especially primary hematological resistance (χ2=7.870, P=0.005), but the difference of CCyR (χ2=0.192, P=0.661), MMR (χ2=0.822, P=0.365), EFS (χ2=0.509, P=0.476), OS (χ2=3.485, P=0.062) were not statistically significant, and multivariate analysis showed that the presence of vPh did not affect OS (RR=0.692, 95%CI 0.393-1.765, P=0.658)、EFS (RR=0.893, 95%CI 0.347-2.132, P=0.126) and PFS (RR=1.176, 95%CI 0.643-2.682, P=0.703). Conclusion: CML-CP patients with vPh and classic Ph had similar demographic and hematological characteristics. Except for 22q11, 9q34, the frequency of chromosome 12q and 1p were higher involved. The most common FISH signal pattern was 2G2R1Y, and different mechanisms had no impact on TKIs therapy. Compared with cases with classic Ph chromosomes, the patients with vPh chromosomes had higher risk of IM primary resistance, especially primary hematological resistance, which can obtain deeper molecular response quickly after changing to second-generation TKIs and didn't affect long-term outcomes and OS.
Cytogenetics
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Fusion Proteins, bcr-abl
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Humans
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Imatinib Mesylate
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Leukemia, Myeloid, Chronic-Phase/drug therapy*
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Philadelphia Chromosome
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Protein Kinase Inhibitors/therapeutic use*
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Protein-Tyrosine Kinases
9.Therapeutic effects of imatinib on chronic myeloid leukemia in different phases and the factors affecting the effects.
Wai-yi ZOU ; Duo-rong XU ; Chang SU ; Juan LI ; Shao-kai LUO
Journal of Southern Medical University 2008;28(9):1660-1662
OBJECTIVETo evaluate the therapeutic effect of imatinib on chronic myeloid leukemia (CML) in different phases and analyze the factors that may affect the effects.
METHODSEighty-five patients with CML in chronic phase, 24 in accelerated phase and 19 in blastic phase patients were treated with imitinib. The hematologic response, cytogenetic response, molecular response, overall survival (OS), progression-free survival (PFS) and adverse events were analyzed in these groups.
RESULTSThe rates of complete hematologic response (CHR), complete cytogenetic response (CCyR) and complete molecular response (CMoR) of the patients in chronic phase were 100%, 82.4% and 21.2%, respectively, and the 5-year OS and PFS of these patients were 92.1% and 84.7%. All these rates were significantly higher than those in patients in accelerated and blastic phases (P<0.0001). The CCyR, CMoR, 5-year OS and PFS in the 42 newly diagnosed patients in chronic phase were 92.9%, 26.3%, 100% and 95.2%, respectively, all significantly higher than those in patients with interferon therapy failure (P<0.001). Severe leukocytopenia and thrombocytopenia occurred at greater frequencey in AP and BP patients than in chronic phase patients (P<0.0001). Non-hematologic toxicity was rarer and milder in patients in chronic phase. Multivariate analysis showed that interferon therapy prior to imitinib treatment and prolonged drug cessation were the independent factors that affected the achievement of cytogenetic response and PFS.
CONCLUSIONEarly imitinib therapy can be effective and safe, and should be used as the first line drug for CML.
Antineoplastic Agents ; therapeutic use ; Benzamides ; Female ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; Leukemia, Myeloid, Chronic-Phase ; drug therapy ; Male ; Piperazines ; therapeutic use ; Pyrimidines ; therapeutic use ; Treatment Outcome
10.Factors influencing severe cytopenia in chronic phase chronic myeloid leukemia patients receiving initial second generation tyrosine kinase inhibitors and its impact on treatment responses and outcomes.
Zi Yu LI ; Ya Zhen QIN ; Yue Yun LAI ; Hong Xia SHI ; Yue HOU ; Xiao Shuai ZHANG ; Qian JIANG
Chinese Journal of Hematology 2023;44(4):295-301
Objective: To explore the influencing covariates of severe neutrophils and/or thrombocytopenia and their effect on treatment response and outcome in patients with chronic-phase chronic myeloid leukemia (CP-CML) receiving initial second-generation tyrosine kinase inhibitors (2G-TKI) . Methods: Data from consecutive patients aged ≥18 years with newly diagnosed CP-CML who received initial 2G-TKI at Peking University People's Hospital from September 2008 to November 2021 were interrogated. Binary logistic regression models and Fine-Gray and Cox regression models were applied. Results: Data from 267 patients who received initial 2G-TKI, including nilotinib (n=239, 89.5% ) and dasatinib (n=28, 10.5% ) , were interrogated. The median age was 36 (range, 18-73) years, and 156 (58.4% ) patients were male. At a median treatment period of 1.0 (0.1-3.0) month, 43 (16.1% ) patients developed grade ≥3 neutrophils and/or thrombocytopenia and recovered within 1.0 (0.1-24.6) month. Male (OR=2.9, 95% CI 1.2-6.8; P=0.018) , age of ≥36 years (OR=3.2, 95% CI 1.4-7.2, P=0.005) , a spleen below a costal margin of ≥7 cm (OR=2.8, 95% CI 1.2-6.6, P=0.020) , and a hemoglobin (HGB) level of <100 g/L (OR=2.9, 95% CI 1.3-6.8, P=0.012) at diagnosis were significantly associated with grade ≥ 3 neutrophils and/or thrombocytopenia. Based on their regression coefficients, male, age of ≥36 years, a spleen below a costal margin of ≥7 cm, and an HGB level of <100 g/L were given 1 point to form a predictive system. All patients were divided into three risk subgroups, and the incidence of severe cytopenia significantly differed among the three groups (P < 0.001) . Grade ≥3 neutrophils and/or thrombocytopenia for >2 weeks was significantly associated with lower cumulative incidences of complete cytogenetic response (CCyR, HR=0.5, 95% CI 0.3-0.7, P<0.001) and major molecular response (MMR, HR=0.4, 95% CI 0.3-0.8, P=0.004) and was not significantly associated with failure, progression, and survival. Conclusion: Male, advanced age, a large spleen, and a low HGB level were significantly associated with severe cytopenia. The four covariates were used to establish a prediction model, in which the incidence of severe cytopenia among different risk groups was significantly different. Severe cytopenia for >2 weeks was a negative factor for responses but not for outcomes.
Humans
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Male
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Adolescent
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Adult
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Female
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Protein Kinase Inhibitors/therapeutic use*
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Tyrosine Protein Kinase Inhibitors
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Treatment Outcome
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Retrospective Studies
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Dasatinib/therapeutic use*
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy*
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Leukemia, Myeloid, Chronic-Phase/drug therapy*
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Thrombocytopenia