The Korean journal of internal medicine · 2016
BCR-ABL1 transcripts (MR4.5) at post-transplant 3 months as an early predictor for long-term outcomes in chronic myeloid leukemia.
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Lee Sung-Eun, Choi Soo Young, Kim Soo-Hyun, Song Hye-Young, Yoo Hea-Lyun, Lee Mi-Young, Kang Ki-Hoon, Hwang Hee-Jeong, Jang Eun-Jung, Kim Dong-Wook
Аннотация
BACKGROUND/AIMS: The aim of this study was to identify the role of BCR-ABL1 transcript level as a predictor for post-transplant relapse and outcome in patients who underwent allogeneic stem cell transplantation (SCT) for chronic phase (CP) chronic myeloid leukemia (CML).
METHODS: Of 101 patients receiving allograft in CML CP, 85 had available quantitative reverse transcriptase polymerase chain reaction data at post-transplant 3 months. These patients were divided into two groups according to molecular response (MR4.5), defined as a BCR-ABL1 transcript level ≤ 0.0032% on the international scale, at 3 months based on receiver operating characteristic curve analysis of relapse.
RESULTS: The 4-year overall survival and event-free survival (EFS) were 80.6% and 57.3%, respectively, and the cumulative incidence of relapse at 4 years was 29.6% after a median follow-up of 126.4 months. We performed multivariate analyses including potential variables to evaluate the early predictive role of MR4.5 at 3 months and found that MR4.5 at 3 months was associated with a higher EFS (p = 0.028) and showed a trend for a lower relapse rate (p = 0.089).
CONCLUSIONS: our results imply that frequent molecular monitoring and immune suppressive therapy modulation are required for patients without reduction of BCR-ABL1 transcripts to this level after SCT.
METHODS: Of 101 patients receiving allograft in CML CP, 85 had available quantitative reverse transcriptase polymerase chain reaction data at post-transplant 3 months. These patients were divided into two groups according to molecular response (MR4.5), defined as a BCR-ABL1 transcript level ≤ 0.0032% on the international scale, at 3 months based on receiver operating characteristic curve analysis of relapse.
RESULTS: The 4-year overall survival and event-free survival (EFS) were 80.6% and 57.3%, respectively, and the cumulative incidence of relapse at 4 years was 29.6% after a median follow-up of 126.4 months. We performed multivariate analyses including potential variables to evaluate the early predictive role of MR4.5 at 3 months and found that MR4.5 at 3 months was associated with a higher EFS (p = 0.028) and showed a trend for a lower relapse rate (p = 0.089).
CONCLUSIONS: our results imply that frequent molecular monitoring and immune suppressive therapy modulation are required for patients without reduction of BCR-ABL1 transcripts to this level after SCT.
Предметные рубрики MeSH
AdolescentAdultArea Under CurveBiomarkers, TumorDisease-Free SurvivalDrug Therapy, CombinationFemaleFusion Proteins, bcr-ablGraft vs Host DiseaseHumansImmunosuppressive AgentsKaplan-Meier EstimateLeukemia, Myelogenous, Chronic, BCR-ABL PositiveMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsProportional Hazards ModelsROC CurveRecurrenceReverse Transcriptase Polymerase Chain ReactionRisk FactorsStem Cell TransplantationTime FactorsTransplantation, HomologousTreatment OutcomeYoung Adult