Document Detail

The early molecular response to imatinib predicts cytogenetic and clinical outcome in chronic myeloid leukaemia.
MedLine Citation:
PMID:  12648069     Owner:  NLM     Status:  MEDLINE    
Real-time quantitative reverse transcription-polymerase chain reaction (Q-RT-PCR) is increasingly used to monitor responses in chronic myeloid leukaemia (CML). The peripheral blood BCR-ABL/ABL ratio, as assessed by Q-RT-PCR, has been shown to correlate with the contemporary cytogenetic response in patients receiving imatinib (Glivec, Gleevec). We have used Q-RT-PCR to monitor the early molecular response to 4 weeks and 3 months of imatinib therapy, in 47 patients with established CML. After 4 weeks of imatinib therapy, patients whose BCR-ABL/ABL ratio had fallen to less than 50% that of baseline had a significantly higher probability of achieving a major cytogenetic response after 6 months of therapy, when compared with those whose ratio did not fall by this amount (P < 0.001). Similarly, patients whose ratio at 3 months was less than 10% of that at baseline had a significantly higher probability of achieving a major cytogenetic remission at 6 months (P < 0.001). Patients who achieved these falls in their BCR-ABL/ABL ratio at either 4 weeks or 3 months had a superior progression-free survival at a median follow-up of 16.5 months (P = 0.01 and 0.003 respectively). These effects were independent of patient age and disease stage. The occurrence of peripheral blood cytopenias sufficiently severe to interrupt therapy was unrelated to progression-free survival. In conclusion, the data suggest that the early trend in the BCR-ABL/ABL ratio may be clinically useful for the early identification of patients destined to fare poorly on imatinib.
Lihui Wang; Kevin Pearson; Julia E Ferguson; Richard E Clark
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of haematology     Volume:  120     ISSN:  0007-1048     ISO Abbreviation:  Br. J. Haematol.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-21     Completed Date:  2003-08-07     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  990-9     Citation Subset:  IM    
Department of Haematology, Royal Liverpool University Hospital, UK.
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MeSH Terms
Aged, 80 and over
Antineoplastic Agents / therapeutic use*
Disease-Free Survival
Follow-Up Studies
Fusion Proteins, bcr-abl / genetics*
Genetic Markers
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*,  genetics,  mortality
Middle Aged
Piperazines / therapeutic use*
Proto-Oncogene Proteins c-abl / genetics*
Pyrimidines / therapeutic use*
Reverse Transcriptase Polymerase Chain Reaction
Treatment Outcome
Reg. No./Substance:
0/Antineoplastic Agents; 0/Fusion Proteins, bcr-abl; 0/Genetic Markers; 0/Piperazines; 0/Pyrimidines; 152459-95-5/imatinib; EC Proteins c-abl

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