[Analysis of Efficacy and Related Factors of Acquired Deep Molecular Response in Chronic Myeloid Leukemia Patients Treated with TKI].

OBJECTIVE

To evaluate the efficacy and related factors of acquired deep molecular response(DMR) for treating patients with chronic myeloid leukemia(CML) by using TKI.

METHODS

The clinical data of 131 TKI-treated patients with CML were analyzed retrospectively. The therapeutic effects of each time-points were evaluated, and the related factors of MR4.5 were analyzed.

RESULTS

The median follow up-time of 131 cases with CML was 24 months (6-120 months), among them the treatment of 30 patient was converted to nilotinib after a median of 12 months (1-69.6 months) with imatinib, and 13 patient was converted to dasatinib treatment after a median of 31.2 month (3.1-87.6 months) with imatinib. After treatment for 3, 6 and 12 month, the rate of major cytogenetic response (MCyR) was 78%, 79.4% and 95.9%, and the complete cytogenetic response (CCyR) rate was 48.8%, 66.7% and 73.5%, respectively. 60% patients obtained BCR-ABLIS<10% at 3 months, 56.3% patients obtained BCR-ABLIS<1% at 6 months, 55.2% patients obtained BCR-ABLIS<0.1% at 12 months. In continued imatinib therapy group, 53 patients (60.9%) obtained MR4.5, and 33 cases (37.9%) obtained stable MR4.5. Multivariate analysis showed that sex, WBC count at the time of diagnosis and BCR-ABLIS level at 3 months were independent factors for obtaining MR4.5. The 3-month BCR-ABLIS level was an independent factor to obtain stable MR4.5. 18 cases (40.9%) in the second-generation TKI group received MR4.5 and the 3-month BCR-ABLIS level was also an independent predictor for MR4.5.

CONCLUSION

The excellent cytogenetic and molecular responses are observed in CML patients treated with cmatinib. Conversion to second-generation TKI therapy for patients with resistant or intolerant to imatinib also can achieve a satisfactory response and a higher rate of deeper molecular remission. The higher incidence of early molecular response predicting MR4.5 and stable MR4.5 is achieved.