伊马替尼治疗早期BCR-ABL转录本水平在251例慢性髓性白血病患者中的预后价值

OBJECTIVE: To understand the prognostic value of early monitoring BCR-ABL transcripts in patients with chronic myeloid leukemia (CML) after treatment with imatinib, and to provide the information for early assessment of prognosis and treatment options. METHODS: The clinical data of 251 patients with CML in chronic phase (CML-CP) who received imatinib as first-line therapy were retrospectively analyzed, the progression-free survival (PFS) and overall survival (OS) between different BCR-ABL transcriptional level at 3 and 6 month after imatinib treatment were compared. Meanwhile, Chi-square test and logistic regression were used to analyze the risk factors for disease progression. RESULTS: At 3 months after imatinib treatment BCR-ABL transcriptional levels>10%, >1%–≤10% and ≤1% were found in 92, 94 and 64 patients, their PFS were 53.3%, 71.3% and 86.2%, respectively. The results showed that the PFS of patients with low BCR-ABL transcriptional levels was significantly superior to that with high BCR-ABL transcriptional levels for CML at 3 months treatment (P<0.05). The OS of three group did not reach statistical significance (92.4% vs 96.8% vs 93.8%, P> 0.05). When 182 patients received imatinib treatment at 6 months, 22 patients with BCR-ABL transcriptional levels>10%, 50>1%–≤10% and 110 ≤1%, their PFS were 27.3% vs 66.0% vs 82.7% (P<0.05), the OS of three groups were 86.4% vs 94.0% vs 100%. There were significant differences among the three groups (P<0.05). Logistic regression confirmed that the level of BCR-ABL transcriptional level at 3 and 6 months after imatinib treatment was independent factor to influence the progress of disease. CONCLUSION: It is important for the prognosis evaluation of CML patients to monitor BCR-ABL transcriptional level at 3 and 6 months after imatinib treatment.