title: The achievement of durable complete cytogenetic remission in late chronic and accelerated phase patients with CML treated with Imatinib mesylate predicts for prolonged response at 6 years.
abstract: Despite the positive results achieved by Imatinib mesylate (Imatinib) in the treatment of chronic myeloid leukemia (CML), over the past several years, Imatinib does not eradicate the leukemic clone. The long-term duration of response to the drug is not known. Long-term follow-up of CML patients treated with Imatinib will ultimately define the durability of such treatment and the frequency of reemergence of progressive disease. We present the results of a 6-year follow-up of 40 CML patients either in chronic or accelerated phase who obtained a durable (>6 months) complete cytogenetic remission (CCyR) after treatment with Imatinib in a single center. In 34 cases CCyR was obtained at an Imatinib dose of 400-600 mg/day and in 6 cases after a dose increase to 600-800 mg/day. At a median follow-up of 68 months, 6 cytogenetic relapses (15%) were observed. No progressions to more advanced phases of disease have been detected during the follow-up period. Cytogenetic relapse was predicted by either a decrease in the amount of BCR-ABL transcript of less than 2 logs after the achievement of CCyR (p=0.0041) or a time-to-CCyR of more than 12 months (p<0.0001). This 6-year follow-up of the efficacy of Imatinib therapy in CML patients who obtained a durable CCyR indicates that the relapses rate is low over this period of observation and that the rate of relapse does not increase over time.
authors.affiliation: University of Milano Bicocca, S. Gerardo Hospital, Monza, Italy.
authors.forename: Rocco G
authors.initials: RG
authors.lastname: Piazza
authors.forename: Vera
authors.initials: V
authors.lastname: Magistroni
authors.forename: Anna
authors.initials: A
authors.lastname: Franceschino
authors.forename: Federica
authors.initials: F
authors.lastname: Andreoni
authors.forename: Lucia
authors.initials: L
authors.lastname: Tornaghi
authors.forename: Federica
authors.initials: F
authors.lastname: Colnaghi
authors.forename: Gianmarco
authors.initials: G
authors.lastname: Corneo
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Pogliani
authors.forename: Carlo
authors.initials: C
authors.lastname: Gambacorti-Passerini
mesh_terms: D000328:Adult; D000368:Aged; D001549:Benzamides; D015331:Cohort Studies; D020732:Cytogenetic Analysis / Q000379:methods*; D003627:Data Interpretation, Statistical; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011743:Pyrimidines / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate; D013995:Time; D016896:Treatment Outcome
chemical_list: D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate