Current survival measures reliably reflect modern sequential treatment in CML: Correlation with prognostic stratifications

Authors

PAVLÍK Tomáš JANOUŠOVÁ Eva MAYER Jiří INDRÁK Karel JAROSOVA Marie KLAMOVA Hana ŽÁČKOVÁ Daniela VOGLOVÁ Jaroslava FABER Edgar KARAS Michal POLAKOVA MACHOVA Katerina RÁČIL Zdeněk DEMEČKOVÁ Eva DEMITROVIČOVÁ Ludmila TOTHOVÁ Elena CHUDEJ Juraj MARKULJAK Imrich CMUNT Eduard KOZAK Tomas MUŽÍK Jan DUŠEK Ladislav

Year of publication 2013
Type Article in Periodical
Magazine / Source American Journal of Hematology
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1002/ajh.23508
Field Oncology and hematology
Keywords CHRONIC MYELOID-LEUKEMIA; TYROSINE KINASE INHIBITORS; COMPLETE CYTOGENETIC RESPONSE; CHRONIC-PHASE; BCR-ABL; MOLECULAR RESPONSE; IMATINIB MESYLATE; INTERFERON-ALPHA; THERAPY; FAILURE
Description Using the data of 723 chronic myeloid leukemia (CML) patients in the chronic phase, we analyzed the prognostic value of the Sokal, Euro, and EUTOS scores as well as the level of BCR-ABL1 and the achievement of complete cytogenetic response (CCgR) at 3 months of imatinib therapy in relation to the so-called current survival measures: the current cumulative incidence (CCI) reflecting the probability of being alive and in CCgR after starting imatinib therapy; the current leukemia-free survival (CLFS) reflecting the probability of being alive and in CCgR after achieving the first CCgR; and the overall survival. The greatest difference between the CCI curves at 5 years after initiating imatinib therapy was observed for the BCR-ABL1 transcripts at 3 months. The 5-year CCI was 94.3% in patients with BCR-ABL1 transcripts10% and 57.1% in patients with BCR-ABL1 transcripts>10% (P=0.005). Therefore, the examination of BCR-ABL1 transcripts at 3 months may help in early identification of patients who are likely to perform poorly with imatinib. On the other hand, CLFS was not significantly affected by the considered stratifications. In conclusion, our results indicate that once the CCgR is achieved, the prognosis is good irrespective of the starting prognostic risks.

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