A half-log increase in BCR-ABL RNA predicts a higher risk of relapse in patients with chronic myeloid leukemia with an imatinib-induced complete cytogenetic response.

A half-log increase in BCR-ABL RNA predicts a higher risk of relapse in patients with chronic myeloid leukemia with an imatinib-induced complete cytogenetic response. Research Abstract Details 

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A half-log increase in BCR-ABL RNA predicts a higher risk of relapse in patients with chronic myeloid leukemia with an imatinib-induced complete cytogenetic response. Abstract Text:

Richard D Press,Chad Galderisi,Rui Yang,Carole Rempfer,Stephanie G Willis,Michael J Mauro,Brian J Druker,Michael W N Deininger,Richard D Press,Chad Galderisi,Rui Yang,Carole Rempfer,Stephanie G Willis,Michael J Mauro,Brian J Druker,Michael W N Deininger,

PURPOSE: Imatinib induces a complete cytogenetic response (CCR) in most chronic myeloid leukemia patients in chronic phase. Although CCR is usually durable, a minority of patients relapse. Biomarkers capable of predicting those CCR patients with a higher risk of relapse would improve therapeutic management. EXPERIMENTAL DESIGN: To assess whether changes in BCR-ABL RNA levels are a prognostic biomarker predictive of relapse, we regularly monitored transcript levels [every 3 months (median)] in 90 patients with CCR during 49 months (median) of imatinib therapy. RESULTS: Throughout follow-up, the 20 patients with eventual relapse had higher transcript levels than the durable responders. Major molecular response (MMR; >3-log reduction of BCR-ABL RNA) was attained by 76 patients (12 with subsequent relapse) and was a significant predictor of prolonged relapse-free survival (P = 0.0008). A minimal 0.5-log increase in transcripts (before relapse; experienced by 42 patients, 16 with subsequent relapse) conveyed a significantly shorter relapse-free survival (P = 0.0017). Loss of MMR (transcript increase to <2.5-log reduction, before relapse; experienced by 33 patients, 11 with subsequent relapse) was also predictive of shortened relapse-free survival (P = 0.0003). A complete molecular response (undetectable transcripts by nested PCR) was attained by 28 MMR patients (one with subsequent relapse) and conveyed a significantly prolonged relapse-free survival (P = 0.0052). CONCLUSIONS: In chronic myeloid leukemia patients with an imatinib-induced CCR, a minimal half-log increase in BCR-ABL RNA (including loss of MMR) is a significant risk factor for future relapse. The achievement of a complete molecular response imparts longer progression-free survival than the achievement of an MMR.

A half-log increase in BCR-ABL RNA predicts a higher risk of relapse in patients with chronic myeloid leukemia with an imatinib-induced complete cytogenetic response. Publishing Authors By Initials

RD Press,C Galderisi,R Yang,C Rempfer,SG Willis,MJ Mauro,BJ Druker,MW Deininger,RD Press,C Galderisi,R Yang,C Rempfer,SG Willis,MJ Mauro,BJ Druker,MW Deininger,

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A half-log increase in BCR-ABL RNA predicts a higher risk of relapse in patients with chronic myeloid leukemia with an imatinib-induced complete cytogenetic response. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Clinical cancer research : an official journal of

VOLUME: 13

Page Numbers: 6136-43

Journal Abbreviation: Clin. Cancer Res.

ISSN: 1078-0432

DAY: 15

MONTH: Oct

YEAR: 2007

A half-log increase in BCR-ABL RNA predicts a higher risk of relapse in patients with chronic myeloid leukemia with an imatinib-induced complete cytogenetic response. Information

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LANGUAGE: eng

NlmUniqueID: 9502500

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AFFILIATION: Department of Pathology, Center for Hematologic Malignancies, Cancer Institute, and Howard Hughes Medical Institute, Oregon Health & Science University, Portland, Oregon 97201, USA. pressr@ohsu.edu

Country: United States

AGENCY: United States NCI

GRANT: R21 CA095203

ACRONYM: CA

MEDLINETA: Clin Cancer Res

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