• M. S. Fominykh
  • K. M. Abdulkadyrov
  • A. G. Turkina
  • V. A. Shuvaev
  • I. S. Martynkevich
  • G. A. Tsaur
  • N. V. Bederak
  • E. Yu Chelysheva
  • O. A. Shukhov
  • A. O. Abdullaev
  • V. Yu Udaleva
  • I. I. Zotova
  • D. I. Shikhbabaeva
  • L. B. Polushkina
  • M. P. Ivanovo
  • E. V. Petrova
  • L. S. Martynenko
  • E. V. Kleina
  • N. Yu Tsybakova

Relevance: Chronic myelogenous leukemia (CML) patients represent the heterogeneous group. Several studies in recent years were aimed to personalize treatment based on individual patients characteristics. Aim of study: The aim of our study was to assess prognostic value of individual BCR-ABL decline rate in the first three months of CML therapy to predict optimal response. Patients and methods: Fifty-four patients with chronic phase CML were included in the study. Forty-one patients started treatment with Imatinîb 400 mg/day, 12 patients started with Nilotinib 600 mg/day and 1 patient started with Dasatinib 100 mg/day. BCR-ABL level was determined by International Scale at the moment of diagnosis and after 3,6 and 12 months with ITK therapy. The ratio of BCR-ABL levels at 3 months to baseline for each patient, frequency of the achievement of the early molecular response at 3 months (10% by IS) and MMR at 12 months were assessed; in addition, we calculated ratio of BCR-ABL levels at 3 months to BCR-ABL levels at 1 month. Twenty-six out of 34 patients (76.5%) with ratio of BCR-ABL levels at 3 months to baseline below than 0,1 achieved MMR at 12 months, while only 9 out of 20 patients (45%) with ratio more than 0,1 had optimal response (p = 0.02). Ratio of BCR-ABL levels at 3 months to BCR-ABL levels at 1 month showed much better results with the same (0.1) cut-off value - 5 out of 6 patients (83.3%) with ratio BCR-ABL levels at 3 months to BCR-ABL levels at 1 month below than 0.1, while only the 1 patient (16.7%) with ratio more than 0.1 achieved optimal response (p = 0.04), respectively. Application of early molecular response at 3 months (10% by IS) yielded worse discrimination results: 33 of 46 (71.7%) patients with BCR-ABL level ≤ 10% at 3 months, whereas 2 of 8 (25%) patients with BCR-ABL > 10% had MMR at 1 year (p = 0.02), respectively. Furthermore, application of our ratio cut-off value in patients with early molecular response (BCR-ABL level ≤ 10% at 3 months) allowed us to reveal additional 5 high-risk patients who have not reached MMR after 1 year of therapy. Conclusion: Our study showed that individual BCR-ABL level decline rate estimated in the first three months of CML therapy from the baseline to the level measured at 3 months might be useful as an optimal predictor of outcome for CML patients (MMR after 1 year of treatment).

Original languageEnglish
Pages (from-to)4-10
Number of pages7
JournalGematologiya i Transfusiologiya
Volume61
Issue number1
DOIs
StatePublished - 1 Jan 2016

    Research areas

  • BCR-ABL, Chronic myeloid leukemia, Individualization of therapy, Major molecular response, Tyrosine kinase inhibitors

    Scopus subject areas

  • Hematology

ID: 46137951