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Observational Study
. 2017 Mar;58(3):150-154.
doi: 10.11622/smedj.2016063. Epub 2016 Mar 31.

The predictive value of early molecular response in chronic myeloid leukaemia patients treated with imatinib in a single real-world medical centre in a developing country

Ping Chong Bee  1 , Veera Sekaran  2 , Richard Rui Jie Ng  1 , Ting Yi Kweh  1 , Gin Gin Gan  1
Affiliations
Observational Study

The predictive value of early molecular response in chronic myeloid leukaemia patients treated with imatinib in a single real-world medical centre in a developing country

Ping Chong Bee et al. Singapore Med J. 2017 Mar.

Abstract

Introduction: The prognosis of patients with chronic myeloid leukaemia (CML) has improved since the introduction of imatinib. However, patients who do not achieve complete cytogenetic response (CCyR) and major molecular response (MMR) have poorer prognosis. Recent clinical trials have demonstrated that early and deeper cytogenetic and molecular responses predict a better long-term outcome. This study aimed to analyse the relationship between early molecular response and clinical outcome in a real-life setting.

Methods: This retrospective study included all patients with CML, in chronic or accelerated phase, who were treated with imatinib at University of Malaya Medical Centre, Malaysia.

Results: A total of 70 patients were analysed. The median follow-up duration was 74 months, and the cumulative percentages of patients with CCyR and MMR were 80.0% and 65.7%, respectively. Overall survival (OS) and event-free survival (EFS) at ten years were 94.3% and 92.9%, respectively. Patients who achieved CCyR and MMR had significantly better OS and EFS than those who did not. At six months, patients who had a BCR-ABL level ≤ 10% had significantly better OS and EFS than those who had a BCR-ABL level > 10%. The target milestone of CCyR at 12 months and MMR at 18 months showed no survival advantage in our patients.

Conclusion: Our data showed that imatinib is still useful as first-line therapy. However, vigilant monitoring of patients who have a BCR-ABL level > 10% at six months of treatment should be implemented so that prompt action can be taken to provide the best outcome for these patients.

Keywords: chronic myeloid leukaemia; complete cytogenetic response; early major molecular response; imatinib; survival.

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Figures

Fig. 1
Fig. 1
Graph shows the overall duration of survival of the patients (n = 70).
Fig. 2
Fig. 2
Graph shows the duration of survival of the patients according to whether they achieved complete cytogenetic response (CCyR).
Fig. 3
Fig. 3
Graph shows the duration of survival of the patients according to whether they achieved major molecular response (MMR).
Fig. 4
Fig. 4
Graphs show the duration of survival of the patients, according to their BCR-ABL levels at (a) three months and (b) six months.
See this image and copyright information in PMC

References

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