title: Proposal of a morphologic bone marrow response score for imatinib mesylate treatment in chronic myelogenous leukemia.
abstract: Cytogenetic and molecular analyses are essential disease-monitoring parameters in chronic myelogenous leukemia (CML) treated with imatinib. However, a bone marrow morphologic response has not been defined. We reviewed bone marrow histology and cytology of 39 imatinib-treated patients with CML over 49 weeks and introduced a morphologic response score. A significant positive correlation with a complete cytogenetic response was shown for absence of dry tap (P = .04) and abnormal megakaryocytes (P < 0.001), normalization of cellularity (P = .001) and reduction of fibrosis (P = .01), myelopoiesis:erythropoiesis index (P = .001), blast (P = .001) and basophil count (P < 0.001). The morphologic score integrating these parameters showed an early and late correlation with cytogenetic response. In conclusion, morphologic criteria for complete cytogenetic response in patients with CML treated with imatinib can be defined. Persistent high-level morphologic abnormalities herald early on a high likelihood to fail treatment and call for more intense or alternative therapy.
authors.affiliation: Institute of Pathology, University Hospital Basel, Switzerland.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lugli
authors.forename: Monika
authors.initials: M
authors.lastname: Ebnoether
authors.forename: Sergio B
authors.initials: SB
authors.lastname: Cogliatti
authors.forename: Alois
authors.initials: A
authors.lastname: Gratwohl
authors.forename: Jakob
authors.initials: J
authors.lastname: Passweg
authors.forename: Urs
authors.initials: U
authors.lastname: Hess
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Korte
authors.forename: Hanne
authors.initials: H
authors.lastname: Hawle
authors.forename: Marianne
authors.initials: M
authors.lastname: Tinguely
authors.forename: Bettina
authors.initials: B
authors.lastname: Borisch
authors.forename: Sara
authors.initials: S
authors.lastname: Mach-Pascual
authors.forename: Silke
authors.initials: S
authors.lastname: Von Juergensonn
authors.forename: André
authors.initials: A
authors.lastname: Tichelli
authors.forename: Stephan
authors.initials: S
authors.lastname: Dirnhofer
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D001853:Bone Marrow / Q000187:drug effects*; D001854:Bone Marrow Cells / Q000166:cytology / Q000187:drug effects*; D002986:Clinical Trials as Topic; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate