Impact of molecular response time achievement on survival of chronic phase chronic myelogenous leukemia patients treated by imatinib
Daftar Isi:
- Background: Chronic myelogenous leukemia (CML) is the most common myeloproliferative disorder. BCR-ABL, the CML cell, contains oncogene makes tyrosine kinase protein which causes cells to grow and reproduce out of control. Recently, a tyrosine kinase inhibitor, namely, imatinib had high efficacy in CML treatment. Importantly, quantification of BCR-ABL transcripts is the most sensitive method to monitor molecular response at deeper levels than the hematologic and cytogenetic response to achieve an excellent outcome. Objective: We described the molecular response, time achievement, and the impact on survival in CML patients. Materials and Methods: A retrospective medical record of 143 BCR-ABL positive chronic phase CML patients have been treated by imatinib 400 mg. The hematological response was determined and the molecular response was assigned by BCR-ABL quantification. The time to achieve major molecular response (MMR) was defined by ≤0.10% ratio of BCR-ABL to ABL control gene and its impact on median survival. Results: In our study, the median age at presentation was 45 years (range 12–73 years). Male to female ratio was 2:1. Patients achieved MMR on 12, 18, and 24 months were 8 (5.5%), 26 (18.2%), and 26 (18.2%), respectively. Patients achieved MMR in <24 months have longer median survival 83.8 (77.4–90.8) months compared to 58.9 (51.7–66.2) of those who failed to achieve it in 24 months, P < 0.001. Conclusion: Our data have shown time to MMR achievement had an impact on survival. The patients that did not achieve MMR had a poorer clinical outcome. Early recognition and prompt treatment of these patients can improve outcomes.