title: BCR-ABL1 Transcript Levels at 3 and 6 Months Are Better for Identifying Chronic Myeloid Leukemia Patients with Poor Outcome in Response to Second-Line Second-Generation Tyrosine Kinase Inhibitors after Imatinib Failure: A Report from a Single Institution.
abstract: Early reduction of BCR-ABL1 transcript levels has been associated with improved outcome in chronic myeloid leukemia (CML) treatment. We evaluated 54 chronic-phase CML patients treated with imatinib who switched therapy to dasatinib (n = 33) or nilotinib (n = 21). BCR-ABL1 transcript levels were measured in peripheral blood using real-time quantitative PCR (RQ-PCR) every 3 months from the start of second-line treatment. Patients with BCR-ABL transcript levels >10% at 3 months and >1% at 6 months had significantly inferior progression-free (PFS) and event-free survival (EFS) than patients with RQ-PCR <10% at 3 months and <1% at 6 months (66 vs. 100%, p = 0.01, and 33 vs. 73%, p = 0.02, respectively). Patients with RQ-PCR <10% at 3 months and >1% at 6 months also had inferior PFS and EFS than patients with RQ-PCR <10% at 3 months and <1% at 6 months (48 vs. 100%, p = 0.002, and 25 vs. 73%, p < 0.0001, respectively). Two measurements of BCR-ABL levels were better than a single one to stratify chronic-phase CML patients as failure after second-line therapy.
authors.forename: Beatriz Felicio
authors.initials: BF
authors.lastname: Ribeiro
authors.forename: Bruna Rocha
authors.initials: BR
authors.lastname: Vergílio
authors.forename: Eliana Cristina Martins
authors.initials: EC
authors.lastname: Miranda
authors.forename: Maria Helena
authors.initials: MH
authors.lastname: Almeida
authors.forename: Marcia Torresan
authors.initials: MT
authors.lastname: Delamain
authors.forename: Rosana Antunes
authors.initials: RA
authors.lastname: da Silveira
authors.forename: Carmino Antonio
authors.initials: CA
authors.lastname: de Souza
authors.forename: Dulcinéia Martins
authors.initials: DM
authors.lastname: Albuquerque
authors.forename: Andrey Dos
authors.initials: AD
authors.lastname: Santos
authors.forename: Vagner Oliveira
authors.initials: VO
authors.lastname: Duarte
authors.forename: Gislaine Borba
authors.initials: GB
authors.lastname: Oliveira-Duarte
authors.forename: Irene
authors.initials: I
authors.lastname: Lorand-Metze
authors.forename: Katia Borgia Barbosa
authors.initials: KB
authors.lastname: Pagnano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000097:blood*; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000097:blood*; D012334:RNA, Neoplasm / Q000097:blood*; D017211:Treatment Failure
chemical_list: C581634:BCR-ABL1 fusion protein, human; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D000068877:Imatinib Mesylate; D016044:Fusion Proteins, bcr-abl