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Prognostic factors associated with a stable MR4.5 achievement in chronic myeloid leukemia patients treated with imatinib

Deep molecular response in chronic myeloid leukemia (CML) patients treated with imatinib is a prerequisite for possible discontinuation. We identify clinico-biologic features linked with the probability of reaching MR4.5 (BCR-ABL/ABL ≤ 0.0032% IS) as a stable response (confirmed on two or more conse...

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Autores principales: Breccia, Massimo, Molica, Matteo, Colafigli, Gioia, Massaro, Fulvio, Quattrocchi, Luisa, Latagliata, Roberto, Mancini, Marco, Diverio, Daniela, Guarini, Anna, Alimena, Giuliana, Foà, Robin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Impact Journals LLC 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800922/
https://www.ncbi.nlm.nih.gov/pubmed/29484130
http://dx.doi.org/10.18632/oncotarget.23691
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author Breccia, Massimo
Molica, Matteo
Colafigli, Gioia
Massaro, Fulvio
Quattrocchi, Luisa
Latagliata, Roberto
Mancini, Marco
Diverio, Daniela
Guarini, Anna
Alimena, Giuliana
Foà, Robin
author_facet Breccia, Massimo
Molica, Matteo
Colafigli, Gioia
Massaro, Fulvio
Quattrocchi, Luisa
Latagliata, Roberto
Mancini, Marco
Diverio, Daniela
Guarini, Anna
Alimena, Giuliana
Foà, Robin
author_sort Breccia, Massimo
collection PubMed
description Deep molecular response in chronic myeloid leukemia (CML) patients treated with imatinib is a prerequisite for possible discontinuation. We identify clinico-biologic features linked with the probability of reaching MR4.5 (BCR-ABL/ABL ≤ 0.0032% IS) as a stable response (confirmed on two or more consecutive determinations). In a series of 208 patients treated with imatinib first-line outside clinical trials, after a median follow-up of 7 years the incidence of stable MR4.5 was 34.6%, obtained in median time of 5.4 years. In univariate analysis, female gender (p = 0.02), lower median age (56.4 vs 58.6, p = 0.03), Sokal risk stratification (p = 0.01) and e14a2 type of transcript (43% vs 31%, p = 0.02) are associated to achievement of a stable MR4.5. In multivariate regression analysis, female gender (HR 1.6, 95% CI: 1.1–2.6; P = 0.022), Sokal risk (HR 1.4, 95% CI: 1.1–2.3; p = 0.03), type of transcript (e14a2 vs e13a2 type, HR 1.6, 95% CI: 1.3–2.9; P = 0.03) and achievement of an early molecular response (EMR) at 3 months (HR 1.5, 95% CI: 1.2–2.8; P = 0.01), retained statistical significance. These clinical and biologic features associated with the achievement of a stable deep molecular response should be taken into account at a time when treatment-free remission strategies are being actively pursued in the management of CML.
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spelling pubmed-58009222018-02-26 Prognostic factors associated with a stable MR4.5 achievement in chronic myeloid leukemia patients treated with imatinib Breccia, Massimo Molica, Matteo Colafigli, Gioia Massaro, Fulvio Quattrocchi, Luisa Latagliata, Roberto Mancini, Marco Diverio, Daniela Guarini, Anna Alimena, Giuliana Foà, Robin Oncotarget Research Paper Deep molecular response in chronic myeloid leukemia (CML) patients treated with imatinib is a prerequisite for possible discontinuation. We identify clinico-biologic features linked with the probability of reaching MR4.5 (BCR-ABL/ABL ≤ 0.0032% IS) as a stable response (confirmed on two or more consecutive determinations). In a series of 208 patients treated with imatinib first-line outside clinical trials, after a median follow-up of 7 years the incidence of stable MR4.5 was 34.6%, obtained in median time of 5.4 years. In univariate analysis, female gender (p = 0.02), lower median age (56.4 vs 58.6, p = 0.03), Sokal risk stratification (p = 0.01) and e14a2 type of transcript (43% vs 31%, p = 0.02) are associated to achievement of a stable MR4.5. In multivariate regression analysis, female gender (HR 1.6, 95% CI: 1.1–2.6; P = 0.022), Sokal risk (HR 1.4, 95% CI: 1.1–2.3; p = 0.03), type of transcript (e14a2 vs e13a2 type, HR 1.6, 95% CI: 1.3–2.9; P = 0.03) and achievement of an early molecular response (EMR) at 3 months (HR 1.5, 95% CI: 1.2–2.8; P = 0.01), retained statistical significance. These clinical and biologic features associated with the achievement of a stable deep molecular response should be taken into account at a time when treatment-free remission strategies are being actively pursued in the management of CML. Impact Journals LLC 2017-12-26 /pmc/articles/PMC5800922/ /pubmed/29484130 http://dx.doi.org/10.18632/oncotarget.23691 Text en Copyright: © 2018 Breccia et al. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/) 3.0 (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Paper
Breccia, Massimo
Molica, Matteo
Colafigli, Gioia
Massaro, Fulvio
Quattrocchi, Luisa
Latagliata, Roberto
Mancini, Marco
Diverio, Daniela
Guarini, Anna
Alimena, Giuliana
Foà, Robin
Prognostic factors associated with a stable MR4.5 achievement in chronic myeloid leukemia patients treated with imatinib
title Prognostic factors associated with a stable MR4.5 achievement in chronic myeloid leukemia patients treated with imatinib
title_full Prognostic factors associated with a stable MR4.5 achievement in chronic myeloid leukemia patients treated with imatinib
title_fullStr Prognostic factors associated with a stable MR4.5 achievement in chronic myeloid leukemia patients treated with imatinib
title_full_unstemmed Prognostic factors associated with a stable MR4.5 achievement in chronic myeloid leukemia patients treated with imatinib
title_short Prognostic factors associated with a stable MR4.5 achievement in chronic myeloid leukemia patients treated with imatinib
title_sort prognostic factors associated with a stable mr4.5 achievement in chronic myeloid leukemia patients treated with imatinib
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800922/
https://www.ncbi.nlm.nih.gov/pubmed/29484130
http://dx.doi.org/10.18632/oncotarget.23691
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