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Medline ® Abstract for Reference 16

of 'Clinical use of tyrosine kinase inhibitors for chronic myeloid leukemia'

16
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Prediction of initial cytogenetic response for subsequent major and complete cytogenetic response to imatinib mesylate therapy in patients with Philadelphia chromosome-positive chronic myelogenous leukemia.
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Kantarjian H, Talpaz M, O'Brien S, Giles F, Rios MB, White K, Garcia-Manero G, Ferrajoli A, Verstovsek S, Wierda W, Kornblau S, Cortes J
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Cancer. 2003;97(9):2225.
 
BACKGROUND: Obtaining a major (Philadelphia chromosome [Ph]of<35%) or a complete cytogenetic response (Ph of 0%) has been associated with excellent long-term survival. Cytogenetic response may continue to improve with therapy. Because early allogeneic stem cell transplantation (SCT) may be associated with a better outcome, early parameters predicting for subsequent cytogenetic responses would optimize the treatment decision-making.
METHODS: The current study was performed to analyze whether early cytogenetic responses may be predictive of later major or complete cytogenetic responses to imatinib mesylate therapy in patients with Ph-positive chronic myelogenous leukemia (CML).
RESULTS: Two hundred sixty-one patients with Ph-positive, chronic-phase CML after failure with interferon therapy who were treated with imatinib mesylate therapy were analyzed. A persistence of 100% Ph-positive cells after>or = 6months of imatinib mesylate therapy was associated with a major cytogenetic response rate of 9-13% and a complete cytogenetic response rate of 0-4%. However, a minor cytogenetic response after 3-12 months of therapy still was associated with high rates of major (68-83%) or complete (35-54%) cytogenetic response rates.
CONCLUSIONS: Patients with Ph-positive, chronic-phase CML who have persistent 100% Ph-positive disease after>or = 6 months of imatinib mesylate therapy may be offered allogeneic SCT or considered for alternative investigational therapies.
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Department of Leukemia, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. hkantarj@mdanderson.org
PMID