Halving Time of BCR-ABL Transcripts as a Precise Predictor for Deep Molecular Response in Patients with Chronic Myeloid Leu-kemia Treated with TKI
10.19746/j.cnki.issn1009-2137.2024.05.007
- VernacularTitle:TKI治疗慢性粒细胞白血病患者BCR-ABLIS减半时间对获得深层分子学反应的早期预测
- Author:
Lan YANG
1
;
Li-Xia CAO
;
Hui-Juan REN
;
Yan-Qiu HAN
Author Information
1. 内蒙古医科大学附属医院血液科,内蒙古呼和浩特 010059
- Keywords:
chronic myeloid leukemia;
tyrosine kinase inhibitor;
imatinib;
BCR-ABL;
halving time
- From:
Journal of Experimental Hematology
2024;32(5):1349-1355
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the early predictive value of halving time(HT)of BCR-ABLIS for deep molecular response(DMR)in patients with chronic myeloid leukemia(CML)treated with tyrosine kinase inhibitor(TKI).Methods:The continuous data of newly diagnosed CML patients with complete case data and first-line imatinib treatment admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2014 to June 2022 were retrospectively analyzed.Combined with the clinical characteristics of the patients and the efficacy analysis at each time point,a logistic regression model was used to explore the independent influencing factors of DMR,and combined HT of BCR-ABLIS with BCR-ABLIS level at 3 months to predict DMR of the patients.Results:Univariate and multivariate analyses showed that HT and 3-month BCR-ABLIS levels were independent influencing factors for MR4,MR4.5,and stable MR4.5(P＜0.05).ROC curve analysis determined that the best cut-off value of HT was 28 days.Compared with patients with HT＞28 d,patients with HT ≤28 d were more likely to obtain DMR at 2,3,and 5 years,respectively(74.2％vs 27.3％,71.2％vs 22.7％,and 63.6％vs 25.0％,all P＜0.001).The patients were divided into 4 groups according to BCR-ABLIS levels at 3 months and HT.Kaplan-Meier analysis showed that the patients in the BCR-ABLIS ≤10％and HT≤28 d group had a higher probability of obtaining cumulative MR4 and MR4.5 than those in the BCR-ABLIS≤10％and HT＞28 d group(P＜0.05);Patients in the BCR-ABLIS＞10％and HT≤28 d group had a higher probability of obtaining cumulative MR4 and MR4.5 than those in the BCR-ABLIS＞10％and HT＞28 d group(P＜0.05).Conclusion:In addition to BCR-ABLIS level,HT of BCR-ABLIS can be used as another important predictor of treatment efficacy in CML patients.The combination of BCR-ABLIS level and HT has a more accurate predictive value for long-term molecular response of CML patients after TKI treatment.
