title: Complete clearance of Ph+ metaphases after 3 months is a very early indicator of good response to imatinib as front-line treatment in chronic myelogenous leukemia.
abstract: OBJECTIVE
  To address the incidence and the prognostic role of a very early standard complete cytogenetic response (CCyR) or all Ph- metaphases (MET-, when <20 cells were evaluable).
  
  
  METHODS
  We revised 182 chronic phase chronic myelogenous leukemia patients treated with frontline imatinib (IM) at two institutions from June 2002 to June 2011.
  
  
  RESULTS
  After 3 months of treatment, 138 patients (75.8%) achieved CCyR/MET- while 44 patients (24.2%) still presented Ph+ metaphases (MET+) (<33%, 24 patients; ≥33%, 20 patients). On univariate analysis, palpable spleen enlargement (p < 0.001), WBC count >100.0 × 10(9)/l at onset (p < 0.001), and male gender (p = 0.019) had a negative impact on achievement of CCyR/MET- at 3 months. Among patients with CCyR/MET- after 3 months, there were 15 failures (10.8%) compared to 21 (47.7%) among patients with MET+ (p < 0.001). The 5-year overall survival was 97.0% in patients CCyR/MET- at 3 months and 91.8% in patients MET+ at 3 months (p = 0.277); the 5-year progression-free survival was 88.2% in patients CCyR/MET- at 3 months and 48.4% in patients MET+ at 3 months (p < 0.001).
  
  
  CONCLUSIONS
  The achievement of CCyR/MET- at 3 months seems to have prognostic relevance and could be a very early and useful indicator of an excellent response to IM beyond European LeukemiaNet guidelines.
authors.affiliation: Department of Cellular Biotechnology and Hematology, La Sapienza University, Rome, Italy. rob.lati@libero.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Latagliata
authors.forename: Alessandro
authors.initials: A
authors.lastname: Isidori
authors.forename: Massimo
authors.initials: M
authors.lastname: Breccia
authors.forename: Ida
authors.initials: I
authors.lastname: Carmosino
authors.forename: Federico
authors.initials: F
authors.lastname: Vozella
authors.forename: Paola
authors.initials: P
authors.lastname: Volpicelli
authors.forename: Paola
authors.initials: P
authors.lastname: Finsinger
authors.forename: Sara
authors.initials: S
authors.lastname: Barulli
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Loglisci
authors.forename: Michelina
authors.initials: M
authors.lastname: Santopietro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Federico
authors.forename: Daniela
authors.initials: D
authors.lastname: Diverio
authors.forename: Mauro
authors.initials: M
authors.lastname: Nanni
authors.forename: Marco
authors.initials: M
authors.lastname: Mancini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Visani
authors.forename: Giuliana
authors.initials: G
authors.lastname: Alimena
mesh_terms: D000368:Aged; D001549:Benzamides; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008677:Metaphase / Q000187:drug effects; D008875:Middle Aged; D010677:Philadelphia Chromosome / Q000187:drug effects*; D010879:Piperazines / Q000627:therapeutic use*; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011743:Pyrimidines / Q000627:therapeutic use*
chemical_list: D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases