MR4 sustained for 12 months is associated with stable deep molecular responses in chronic myeloid leukemia
File(s)
Author(s)
Type
Journal Article
Abstract
The majority of patients with newly diagnosed chronic myeloid leukaemia will enjoy a life expectancy equivalent to that of unaffected individuals, but will remain on life-long treatment with a concomitant requirement for on-going hospital interactions for molecular monitoring and drug dispensing. In order to determine more accurately the frequency of monitoring required, we performed a real-life retrospective single-centre cohort study of 450 patients with chronic myeloid leukaemia in at least major molecular remission (MR3) to analyse the risk of loss of MR3 (defined as at least 2 consecutive RT-qPCR results >0.1% IS). Patient who achieved sustained MR4 (sMR4, BCR-ABL1 RT-qPCR <0.01% IS for 12 months) had a probability of loss of MR3 at 1 and 5 years of 0 and 2.6% (95% CI,1.2-5.4) respectively, compared to 4.4% (95% CI, 1.9-9.8) and 25.4% (95% CI, 16.7-36.7) respectively, in those who achieved sustained MR3 (sMR3) but not sMR4 (p <0.001). No patient who improved their response to a deep molecular level (at least MR4) lost MR3 if they were considered compliant, had no history of resistance and remained on standard dose TKI. MR4 maintained for at least 1 year represents a secure response threshold for patients with chronic myeloid leukaemia, after which no MR3 loss occurs if certain conditions are satisfied (standard TKI dose, full compliance and lack of previous TKI resistance). This finding may justify reduction of the frequency of hospital interaction, with an associated positive impact on quality of life, survivorship and economic burden to both patients and healthcare providers.
Date Issued
2019-11
Date Acceptance
2019-03-21
Citation
Haematologica, 2019, 104 (11), pp.2206-2214
ISSN
0390-6078
Publisher
Ferrata Storti Foundation
Start Page
2206
End Page
2214
Journal / Book Title
Haematologica
Volume
104
Issue
11
Copyright Statement
© 2019, Ferrata Storti Foundation. Accepted manuscript published open access online. Material published in Haematologica is covered by copyright. All rights are reserved to the Ferrata Storti Foundation. Use of published material is allowed under the following terms and conditions:https://creativecommons.org/licenses/by-nc/4.0/legalcode. Copies of published material are allowed for personal or internal use. Sharing published material for non-commercial purposes is subject to the following conditions:https://creativecommons.org/licenses/by-nc/4.0/legalcode, sect. 3. Reproducing and sharing published material for commercial purposes is not allowed without permission in writing from the publisher.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30923102
PII: haematol.2018.214809
Subjects
Chronic Myelogenous Leukemia
Cytogenetics and Molecular Genetics
Minimal Residual Disease
Molecular monitoring
Publication Status
Published
Coverage Spatial
Italy
Date Publish Online
2019-03-28