Early BCR-ABL1 decline in imatinib-treated patients with chronic myeloid leukemia: results from a multicenter study of the Chinese CML alliance.
Early BCR-ABL1 decline in imatinib-treated patients with chronic myeloid leukemia: results from a multicenter study of the Chinese CML alliance.
复制标题
伊马替尼治疗的慢性粒细胞白血病患者早期 BCR-ABL1 下降：中国 CML 联盟多中心研究结果
DOI：
10.1038/s41408-018-0093-4
复制
发表时间：
2018-06-15
影响因子：
12.8
通讯作者：
Hou M
中科院分区：
文献类型：
--
作者：
Zhang J;Wang Y;Wang J;Hu J;Chen S;Jin J;Liu T;Zhou J;Hu Y;Ma D;Huang X;Ji C;Hou M
早期分子反应可以很好地预测慢性髓细胞白血病(CML)的预后，早期反应标志可以识别可能从早期治疗转换中受益的高危患者。在这项研究中，我们评估了476名接受伊马替尼一线治疗的中国慢性期CML患者的早期分子反应标志物的最相关界值(3个月时的BCR-ABL1值、对数减少和从诊断到3个月之间的减半时间)。对于3个月bcr-abl1≤降低10%的324名患者，所有结果都明显优于；Bcr-abl1减半时间≤为22天，结果最好。此外，减半时间44天和bcr-abl1>；10%的患者预后明显最差。重要的是，多元回归分析表明，在0.61的3个月时计算的BCR-ABL1对数减少是唯一对OS有显著预测的变量。我们的结果强调了bcr-abl1最初快速下降对预测满意结果的重要性。我们的数据支持这样的证据，即在早期时间点监测BCR-ABL1值有助于准确评估反应并最终指导关于治疗干预时机的临床决策。
An early molecular response is spectacularly predictive of outcome in chronic myeloid leukemia (CML) and early response landmarks may identify the high-risk patients likely to be benefit from an early therapy switch. In this study, we evaluated the most relevant cutoffs for early molecular response markers (BCR-ABL1 values at 3 months, log reduction and halving time between diagnosis and 3 months) in 476 first-line imatinib-treated Chinese patients with chronic phase CML. All outcomes were significantly superior for the 324 patients with 3-month BCR-ABL1 ≤10%, so did for the 270 patients with BCR-ABL1 >0.61 log reduction. BCR-ABL1 halving time ≤22 days was identified for patients with the most favorable outcome. Moreover, the prognosis was significantly poorest for patients with both halving time >44 days and BCR-ABL1 >10%. Importantly, multivariate regression analysis demonstrated that a BCR-ABL1 log reduction calculated at 3 months of 0.61 was the only variable that significantly predicted for OS. Our results highlight the importance of rapid initial decline of BCR-ABL1 in predicting satisfactory outcome. Our data support the evidence that monitoring BCR-ABL1 values at an early time point could contribute to accurately assess response and ultimately guide clinical decisions regarding the timing of therapeutic intervention.
登录
查看更多内容
影响因子：
158.5
作者：
Druker, Brian J.;Guilhot, Francois;Larson, Richard A.
通讯作者：
Larson, Richard A.
影响因子：
11.4
作者：
Hochhaus, A.;O'Brien, S. G.;Larson, R. A.
通讯作者：
Larson, R. A.
酪氨酸激酶抑制剂治疗1个月后，BCR-ABL1早期的转录本作为慢性髓样白血病的治疗反应指标。
影响因子：
3.7
作者：
El Missiry M;Hjorth-Hansen H;Richter J;Olson-Strömberg U;Stenke L;Porkka K;Kreutzman A;Mustjoki S
通讯作者：
Mustjoki S
影响因子：
45.3
作者：
Branford, Susan;Kim, Dong-Wook;Mueller, Martin C.
通讯作者：
Mueller, Martin C.
影响因子：
12.8
作者：
Iriyama, Noriyoshi;Fujisawa, Shin;Sakamaki, Hisashi
通讯作者：
Sakamaki, Hisashi