title: Achieving a major molecular response at the time of a complete cytogenetic response (CCgR) predicts a better duration of CCgR in imatinib-treated chronic myeloid leukemia patients.
abstract: OBJECTIVE
  Most patients with chronic-phase chronic myeloid leukemia (CML) who receive imatinib achieve a complete cytogenetic remission (CCgR) and low levels of BCR-ABL transcripts. CCgR is durable in the majority of patients but relapse occurs in a subset.
  
  
  METHODS
  To determine the potential of quantitative reverse transcription-PCR of BCR-ABL to predict cytogenetic relapse, we serially monitored residual disease in 97 CML patients with an imatinib-induced CCgR. Patients with late chronic phase CML after IFN-alpha failure were treated with imatinib (400 mg daily).
  
  
  RESULTS
  During the imatinib median follow-up time of 36 months (range, 12-54 months), disease monitoring occurred by cytogenetics and quantitative PCR. Twenty percent of patients experienced cytogenetic relapse at a median of 18 months after CCgR and a median of 24 months after starting imatinib. None of the possible prognostic factors studied in univariate and multivariate analyses seemed to predict for loss of cytogenetic response but the reduction of BCR-ABL transcript levels at the time of CCgR is an important prognostic factor.
  
  
  CONCLUSIONS
  In our study, we showed not only that achieving a major molecular remission at 12 months is predictive of a durable cytogenetic remission but also that patients who achieved a major molecular remission (expressed both as the BCR-ABL/beta2 microglobulin ratio % <0.0005 and as a 3-log reduction from median baseline value) already at the time of first achieving a CCgR have significantly longer cytogenetic remission durations than those without this magnitude of molecular response (P < 0.05).
authors.affiliation: Institute of Hematology and Medical Oncology Seràgnoli, University of Bologna, Bologna, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Iacobucci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Saglio
authors.forename: Gianantonio
authors.initials: G
authors.lastname: Rosti
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Testoni
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Pane
authors.forename: Marilina
authors.initials: M
authors.lastname: Amabile
authors.forename: Angela
authors.initials: A
authors.lastname: Poerio
authors.forename: Simona
authors.initials: S
authors.lastname: Soverini
authors.forename: Simona
authors.initials: S
authors.lastname: Bassi
authors.forename: Daniela
authors.initials: D
authors.lastname: Cilloni
authors.forename: Renato
authors.initials: R
authors.lastname: Bassan
authors.forename: Massimo
authors.initials: M
authors.lastname: Breccia
authors.forename: Francesco
authors.initials: F
authors.lastname: Lauria
authors.forename: Barbara
authors.initials: B
authors.lastname: Izzo
authors.forename: Serena
authors.initials: S
authors.lastname: Merante
authors.forename: Francesco
authors.initials: F
authors.lastname: Frassoni
authors.forename: Stefania
authors.initials: S
authors.lastname: Paolini
authors.forename: Enrico
authors.initials: E
authors.lastname: Montefusco
authors.forename: Michele
authors.initials: M
authors.lastname: Baccarani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinelli
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D023381:Endpoint Determination; D005260:Female; D016313:Genes, abl / Q000235:genetics*; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D010879:Piperazines / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use*; D012074:Remission Induction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors; D016896:Treatment Outcome; D001613:beta 2-Microglobulin
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D001613:beta 2-Microglobulin; D000068877:Imatinib Mesylate