Predictive Factors for Molecular Response in Chronic Myeloid Leukemia: Reduction Ratio and Halving Time of IS Transcript Levels

Overview

Journal Turk J Haematol

Specialty Hematology

Date 2022 May 27

PMID 35620443

Authors

Funda Ceran

Sema Akinci

Mehmet Ali Ucar

Gulten Korkmaz

Mehmet Gunduz

Busranur Cavdarli

Sule Mine Bakanay

Mesude Falay

Simten Dagdas

Imdat Dilek

Gulsum Ozet

Affiliations

Soon will be listed here.

Abstract

Objective: Achieving an early molecular response (EMR) is crucial for improving the prognosis of patients with chronic myeloid leukemia (CML). The halving time (HT) and reduction ratio (RR) of transcript levels have recently emerged as additional prognostic indexes besides the International Scale (IS). We aimed to investigate the prognostic role of transcript levels, HT, and RR on molecular response kinetics at 3 months in patients with newly diagnosed chronic-phase (CP)-CML.

Materials And Methods: Forty patients with CP-CML who received first-line imatinib treatment were included in this study. transcript levels and molecular responses at baseline and at 3, 6, 12, and 24 months of treatment were evaluated retrospectively. Major molecular response (MMR) at 12 months and event-free survival (EFS) were determined as primary endpoints and the effects of treatment kinetics on these parameters were examined.

Results: Of the 40 patients, IS was ≤10% at 3 months in 72.5%, representing EMR. The rate of event occurrence was 45.5% in patients with IS of >10%, whereas it was 6.9% in those with IS of ≤10% (p=0.004). MMR was detected in 62.1% of the patients with EMR and in 9.1% of those without EMR (p=0.003). The cut-off value for achieving MMR was 24 days for HT and 0.04 for RR. Deep molecular response (DMR) at 24 months was associated with HT of ≤24 days and RR of ≤0.04. EFS was found to be significantly better in the group with IS of ≤10% and HT of ≤24 days (p=0.001) and in the group with IS of ≤10% and RR of ≤0.04 (p=0.007) compared to others.

Conclusion: Our findings revealed that MMR could be predicted via EMR as well as by HT and RR. Additionally, HT of ≤24 days and RR of ≤0.04 were more important than IS of ≤10% in achieving DMR at 24 months, and the combination of IS of ≤10% with both HT of ≤24 days and RR of ≤0.04 has the best predictive value for EFS.

Citing Articles

Initial Rate of Decline for Response Prediction in Chronic Myeloid Leukemia.

Branford S Turk J Haematol. 2022; 39(3):204-205.

PMID: 35699277 PMC: 9421342. DOI: 10.4274/tjh.galenos.2022.2022.0247.

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