title: Low-level Bcr-Abl mutations are very rare in chronic myeloid leukemia patients who are in major molecular response on first-line nilotinib.
abstract: We investigated whether low-level Bcr-Abl kinase domain mutations can be detected in patients who have stable responses to first-line nilotinib-like it is known to happen in patients receiving imatinib. We screened for mutations twelve such patients by cloning and sequencing. Only one case was found to harbor mutations at low levels (including a T315I). However, major molecular response (MMR) was maintained and it even improved to complete molecular response. Our results suggest that a) Bcr-Abl mutations, even at low level, seem to be very rare in patients in MMR on first-line nilotinib; b) low-level mutations do not always predict for subsequent relapse.
authors.affiliation: Department of Hematology/Oncology, University of Bologna and S.Orsola-Malpighi Hospital, Bologna, Italy. simona.soverini@tin.it
authors.forename: Simona
authors.initials: S
authors.lastname: Soverini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gnani
authors.forename: Caterina
authors.initials: C
authors.lastname: De Benedittis
authors.forename: Fausto
authors.initials: F
authors.lastname: Castagnetti
authors.forename: Gabriele
authors.initials: G
authors.lastname: Gugliotta
authors.forename: Ilaria
authors.initials: I
authors.lastname: Iacobucci
authors.forename: Francesca
authors.initials: F
authors.lastname: Palandri
authors.forename: Gianantonio
authors.initials: G
authors.lastname: Rosti
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Testoni
authors.forename: Simona
authors.initials: S
authors.lastname: Luatti
authors.forename: Giulia
authors.initials: G
authors.lastname: Marzocchi
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*; D001483:Base Sequence; D004252:DNA Mutational Analysis; D004273:DNA, Neoplasm / Q000235:genetics; D019008:Drug Resistance, Neoplasm / Q000235:genetics; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000235:genetics*; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009154:Mutation / Q000235:genetics*; D016133:Polymerase Chain Reaction; D011743:Pyrimidines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004273:DNA, Neoplasm; D011743:Pyrimidines; D016044:Fusion Proteins, bcr-abl; C498826:nilotinib