Purpose: The achievement of a major molecular response (MMolR) at 12 months is a surrogate marker of progression-free survival in chronic myeloid leukemia patients treated with imatinib. Experimental Design: We evaluated the prognostic value of the long-term evolution of the molecular response based on a retrospective analysis of 130 late chronic phase chronic myeloid leukemia patients who achieved a complete cytogenetic response (CCgR) with 400 mg/d imatinib and have now a median follow-up of 72 months (range, 48-77). Results: In 71 (55%) patients, molecular response was consistently major (stable MMolR); in 19 (15%) patients, molecular response was occasionally less than major (unstable MMolR); in 40 (30%) patients, MMolR was never achieved (never MMolR) during all the course of CCgR. Patients with stable MMolR had a longer CCgR duration and a significantly better progression- free survival compared with patients with absent or unstable MMolR. The achievement of a MMolR, if maintained continuously, conferred a marked long-term stability to the CCgR: patients with a stable MMol R have a significantly lower risk of losing the CCgR than patients with unstable and never MMolR (4% versus 21%, P = 0.03, and 4% versus 33%, P < 0.0001, respectively). Finally, if a MMolR is not maintained consistently, the risk of losing the CCgR is higher but not significantly than if it is never achieved (33% versus 21%, P = 0.5). Conclusions: These data confirm that achieving a MMolR is prognostically important but point out that the prognostic value of achieving a MMolR is greater if the response is confirmed and stable. © 2009 American Association for Cancer Research.

Treatment of philadelphia-positive chronic myeloid leukemia with imatinib: Importance of a stable molecular response / F., Palandri; I., Iacobucci; S., Soverini; F., Castagnetti; A., Poerio; N., Testoni; Alimena, Giuliana; M., Breccia; G., Rege Cambrin; M., Tiribelli; R., Varaldo; E., Abruzzese; B., Martino; L., Luciano; F., Pane; G., Saglio; Martinelli, Giovanni; M., Baccarani; G., Rosti. - In: CLINICAL CANCER RESEARCH. - ISSN 1078-0432. - STAMPA. - 15:3(2009), pp. 1059-1063. [10.1158/1078-0432.ccr-08-1195]

Treatment of philadelphia-positive chronic myeloid leukemia with imatinib: Importance of a stable molecular response

ALIMENA, Giuliana;M. Breccia;MARTINELLI, GIOVANNI;
2009

Abstract

Purpose: The achievement of a major molecular response (MMolR) at 12 months is a surrogate marker of progression-free survival in chronic myeloid leukemia patients treated with imatinib. Experimental Design: We evaluated the prognostic value of the long-term evolution of the molecular response based on a retrospective analysis of 130 late chronic phase chronic myeloid leukemia patients who achieved a complete cytogenetic response (CCgR) with 400 mg/d imatinib and have now a median follow-up of 72 months (range, 48-77). Results: In 71 (55%) patients, molecular response was consistently major (stable MMolR); in 19 (15%) patients, molecular response was occasionally less than major (unstable MMolR); in 40 (30%) patients, MMolR was never achieved (never MMolR) during all the course of CCgR. Patients with stable MMolR had a longer CCgR duration and a significantly better progression- free survival compared with patients with absent or unstable MMolR. The achievement of a MMolR, if maintained continuously, conferred a marked long-term stability to the CCgR: patients with a stable MMol R have a significantly lower risk of losing the CCgR than patients with unstable and never MMolR (4% versus 21%, P = 0.03, and 4% versus 33%, P < 0.0001, respectively). Finally, if a MMolR is not maintained consistently, the risk of losing the CCgR is higher but not significantly than if it is never achieved (33% versus 21%, P = 0.5). Conclusions: These data confirm that achieving a MMolR is prognostically important but point out that the prognostic value of achieving a MMolR is greater if the response is confirmed and stable. © 2009 American Association for Cancer Research.
2009
01 Pubblicazione su rivista::01a Articolo in rivista
Treatment of philadelphia-positive chronic myeloid leukemia with imatinib: Importance of a stable molecular response / F., Palandri; I., Iacobucci; S., Soverini; F., Castagnetti; A., Poerio; N., Testoni; Alimena, Giuliana; M., Breccia; G., Rege Cambrin; M., Tiribelli; R., Varaldo; E., Abruzzese; B., Martino; L., Luciano; F., Pane; G., Saglio; Martinelli, Giovanni; M., Baccarani; G., Rosti. - In: CLINICAL CANCER RESEARCH. - ISSN 1078-0432. - STAMPA. - 15:3(2009), pp. 1059-1063. [10.1158/1078-0432.ccr-08-1195]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/32506
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