title: Evaluation of 5-year imatinib treatment of 458 patients with CP-CML in routine clinical practice and prognostic impact of different BCR-ABL cutoff levels.
abstract: We evaluated responses to the treatment and long-term outcomes of chronic myeloid leukemia patients treated with imatinib as first-line treatment in routine clinical setting from two countries with centralized tyrosine kinase inhibitors (TKIs) treatment. We assessed prognostic significance of European LeukemiaNet (ELN) 2006- and 2009-defined responses and the prognostic value of molecular responses at defined time points on 5-year survivals. Among the cumulative rates of incidence of hematologic, cytogenetic, and molecular responses and all important survival parameters, we evaluated the prognostic significance of different BCR-ABL transcript-level ratios (≤1%; >1%-≤10%; >10%) at 3, 6, 12, and 18 months (n = 199). The ELN optimal response criteria and their predictive role were significantly beneficial for event-free survival at all given time points. We found significant improvement in survivals of patients with BCR-ABL lower than 10% in the 6th and 12th months. Significantly better outcome was found in patients who achieved major molecular response (MMR) in the 12th month. The cumulative incidences of complete cytogenetic response (CCyR) and MMR were significantly associated with the molecular response in the 3rd month. The ELN response criteria and their predictive role were helpful at given time points; however, the 2009 definition did not significantly alter the prognostic accuracy compared with that of the 2006 definition. The significant value was observed for cytogenetic responses at the 6th and 12th month. Moreover, progression-free and event-free survivals were improved with MMR at the 12th month.
authors: Institute of Hematology and Blood Transfusion Prague, Czech Republic. hana.klamova@uhkt.cz
authors: Hana
authors: H
authors: Klamová
authors: Kateřina Machová
authors: KM
authors: Poláková
authors: Jan
authors: J
authors: Mužík
authors: Zdeněk
authors: Z
authors: Ráčil
authors: Daniela
authors: D
authors: Záčková
authors: Kateřina
authors: K
authors: Steinerová
authors: Michal
authors: M
authors: Karas
authors: Edgar
authors: E
authors: Faber
authors: Eva
authors: E
authors: Demečková
authors: Zuzana
authors: Z
authors: Michalovičová-Sninská
authors: Jaroslava
authors: J
authors: Voglová
authors: Ludmila
authors: L
authors: Demitrovičová
authors: Eva
authors: E
authors: Mikušková
authors: Elena
authors: E
authors: Tóthová
authors: Juraj
authors: J
authors: Chudej
authors: Imrich
authors: I
authors: Markuljak
authors: Eduard
authors: E
authors: Cmunt
authors: Jana
authors: J
authors: Moravcová
authors: Dana
authors: D
authors: Dvořáková
authors: Kyra
authors: K
authors: Michalová
authors: Marie
authors: M
authors: Jarošová
authors: Markéta Marková
authors: MM
authors: Sťastná
authors: Petr
authors: P
authors: Cetkovský
authors: Ladislav
authors: L
authors: Dušek
authors: Vladimír
authors: V
authors: Koza
authors: Marek
authors: M
authors: Trněný
authors: Karel
authors: K
authors: Indrák
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides / Q000627:therapeutic use*; D016044:Fusion Proteins, bcr-abl / Q000235:genetics; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000235:genetics; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D016044:Fusion Proteins, bcr-abl
keywords: BCR-ABL ratios; CML; ELN definitions; imatinib
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