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Achieving a major molecular response at the time of a complete cytogenetic response (CCgR) predicts a better duration of CCgR in imatinib-treated chronic myeloid leukemia patients.
Clin Cancer Res 2006; 12(10):3037-42CC

Abstract

PURPOSE

Most patients with chronic-phase chronic myeloid leukemia (CML) who receive imatinib achieve a complete cytogenetic remission (CCgR) and low levels of BCR-ABL transcripts. CCgR is durable in the majority of patients but relapse occurs in a subset.

EXPERIMENTAL DESIGN

To determine the potential of quantitative reverse transcription-PCR of BCR-ABL to predict cytogenetic relapse, we serially monitored residual disease in 97 CML patients with an imatinib-induced CCgR. Patients with late chronic phase CML after IFN-alpha failure were treated with imatinib (400 mg daily).

RESULTS

During the imatinib median follow-up time of 36 months (range, 12-54 months), disease monitoring occurred by cytogenetics and quantitative PCR. Twenty percent of patients experienced cytogenetic relapse at a median of 18 months after CCgR and a median of 24 months after starting imatinib. None of the possible prognostic factors studied in univariate and multivariate analyses seemed to predict for loss of cytogenetic response but the reduction of BCR-ABL transcript levels at the time of CCgR is an important prognostic factor.

CONCLUSIONS

In our study, we showed not only that achieving a major molecular remission at 12 months is predictive of a durable cytogenetic remission but also that patients who achieved a major molecular remission (expressed both as the BCR-ABL/beta2 microglobulin ratio % <0.0005 and as a 3-log reduction from median baseline value) already at the time of first achieving a CCgR have significantly longer cytogenetic remission durations than those without this magnitude of molecular response (P < 0.05).

Authors+Show Affiliations

Institute of Hematology and Medical Oncology Seràgnoli, University of Bologna, Bologna, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16707599

Citation

Iacobucci, Ilaria, et al. "Achieving a Major Molecular Response at the Time of a Complete Cytogenetic Response (CCgR) Predicts a Better Duration of CCgR in Imatinib-treated Chronic Myeloid Leukemia Patients." Clinical Cancer Research : an Official Journal of the American Association for Cancer Research, vol. 12, no. 10, 2006, pp. 3037-42.
Iacobucci I, Saglio G, Rosti G, et al. Achieving a major molecular response at the time of a complete cytogenetic response (CCgR) predicts a better duration of CCgR in imatinib-treated chronic myeloid leukemia patients. Clin Cancer Res. 2006;12(10):3037-42.
Iacobucci, I., Saglio, G., Rosti, G., Testoni, N., Pane, F., Amabile, M., ... Martinelli, G. (2006). Achieving a major molecular response at the time of a complete cytogenetic response (CCgR) predicts a better duration of CCgR in imatinib-treated chronic myeloid leukemia patients. Clinical Cancer Research : an Official Journal of the American Association for Cancer Research, 12(10), pp. 3037-42.
Iacobucci I, et al. Achieving a Major Molecular Response at the Time of a Complete Cytogenetic Response (CCgR) Predicts a Better Duration of CCgR in Imatinib-treated Chronic Myeloid Leukemia Patients. Clin Cancer Res. 2006 May 15;12(10):3037-42. PubMed PMID: 16707599.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Achieving a major molecular response at the time of a complete cytogenetic response (CCgR) predicts a better duration of CCgR in imatinib-treated chronic myeloid leukemia patients. AU - Iacobucci,Ilaria, AU - Saglio,Giuseppe, AU - Rosti,Gianantonio, AU - Testoni,Nicoletta, AU - Pane,Fabrizio, AU - Amabile,Marilina, AU - Poerio,Angela, AU - Soverini,Simona, AU - Bassi,Simona, AU - Cilloni,Daniela, AU - Bassan,Renato, AU - Breccia,Massimo, AU - Lauria,Francesco, AU - Izzo,Barbara, AU - Merante,Serena, AU - Frassoni,Francesco, AU - Paolini,Stefania, AU - Montefusco,Enrico, AU - Baccarani,Michele, AU - Martinelli,Giovanni, AU - ,, PY - 2006/5/19/pubmed PY - 2006/7/27/medline PY - 2006/5/19/entrez SP - 3037 EP - 42 JF - Clinical cancer research : an official journal of the American Association for Cancer Research JO - Clin. Cancer Res. VL - 12 IS - 10 N2 - PURPOSE: Most patients with chronic-phase chronic myeloid leukemia (CML) who receive imatinib achieve a complete cytogenetic remission (CCgR) and low levels of BCR-ABL transcripts. CCgR is durable in the majority of patients but relapse occurs in a subset. EXPERIMENTAL DESIGN: To determine the potential of quantitative reverse transcription-PCR of BCR-ABL to predict cytogenetic relapse, we serially monitored residual disease in 97 CML patients with an imatinib-induced CCgR. Patients with late chronic phase CML after IFN-alpha failure were treated with imatinib (400 mg daily). RESULTS: During the imatinib median follow-up time of 36 months (range, 12-54 months), disease monitoring occurred by cytogenetics and quantitative PCR. Twenty percent of patients experienced cytogenetic relapse at a median of 18 months after CCgR and a median of 24 months after starting imatinib. None of the possible prognostic factors studied in univariate and multivariate analyses seemed to predict for loss of cytogenetic response but the reduction of BCR-ABL transcript levels at the time of CCgR is an important prognostic factor. CONCLUSIONS: In our study, we showed not only that achieving a major molecular remission at 12 months is predictive of a durable cytogenetic remission but also that patients who achieved a major molecular remission (expressed both as the BCR-ABL/beta2 microglobulin ratio % <0.0005 and as a 3-log reduction from median baseline value) already at the time of first achieving a CCgR have significantly longer cytogenetic remission durations than those without this magnitude of molecular response (P < 0.05). SN - 1078-0432 UR - https://www.unboundmedicine.com/medline/citation/16707599/Achieving_a_major_molecular_response_at_the_time_of_a_complete_cytogenetic_response__CCgR__predicts_a_better_duration_of_CCgR_in_imatinib_treated_chronic_myeloid_leukemia_patients_ L2 - http://clincancerres.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=16707599 DB - PRIME DP - Unbound Medicine ER -