BCR-ABL₁ transcripts (MR(4.5)) at post-transplant 3 months as an early predictor for long-term outcomes in chronic myeloid leukemia.
- Author:
Sung Eun LEE
1
;
Soo Young CHOI
;
Soo Hyun KIM
;
Hye Young SONG
;
Hea Lyun YOO
;
Mi Young LEE
;
Ki Hoon KANG
;
Hee Jeong HWANG
;
Eun Jung JANG
;
Dong Wook KIM
Author Information
- Publication Type:Original Article
- Keywords: Leukemia, myelogenous, chronic, BCR-ABL positive; Allogeneic stem cell transplantation; Post-transplant relapse
- MeSH: Allografts; Disease-Free Survival; Follow-Up Studies; Humans; Incidence; Leukemia, Myelogenous, Chronic, BCR-ABL Positive*; Multivariate Analysis; Recurrence; Reverse Transcriptase Polymerase Chain Reaction; ROC Curve; Stem Cell Transplantation
- From:The Korean Journal of Internal Medicine 2017;32(1):125-136
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: The aim of this study was to identify the role of BCR-ABL1 transcript level as a predictor for post-transplant relapse and outcome in patients who underwent allogeneic stem cell transplantation (SCT) for chronic phase (CP) chronic myeloid leukemia (CML). METHODS: Of 101 patients receiving allograft in CML CP, 85 had available quantitative reverse transcriptase polymerase chain reaction data at post-transplant 3 months. These patients were divided into two groups according to molecular response (MR(4.5)), defined as a BCR-ABL₁ transcript level ≤ 0.0032% on the international scale, at 3 months based on receiver operating characteristic curve analysis of relapse. RESULTS: The 4-year overall survival and event-free survival (EFS) were 80.6% and 57.3%, respectively, and the cumulative incidence of relapse at 4 years was 29.6% after a median follow-up of 126.4 months. We performed multivariate analyses including potential variables to evaluate the early predictive role of MR(4.5) at 3 months and found that MR(4.5) at 3 months was associated with a higher EFS (p = 0.028) and showed a trend for a lower relapse rate (p = 0.089). CONCLUSIONS: our results imply that frequent molecular monitoring and immune suppressive therapy modulation are required for patients without reduction of BCR-ABL1 transcripts to this level after SCT.
