title: Deep molecular responses achieved in chronic myeloid leukemia in chronic phase patients with BCR-ABL1 >10% at 3 months who are early switched to nilotinib.
abstract: OBJECTIVE
  There are still controversies about whether or when to change therapy for those chronic myeloid leukemia in chronic phase (CML-CP) patients with BCR-ABL1 transcript level at 3 months higher than 10%. Here we studied the clinical significance of early switching to nilotinib in CML-CP patients with BCR-ABL1 >10% at 3 months.
  
  
  METHODS
  We investigated 495 first-line imatinib-treated patients with CML-CP and identified 117 (23.6%) patients with BCR-ABL1 >10% at 3 months, including 46 patients with warning response defined according to ELN-2013 recommendations. In 46 patients with warning response, 26 of them continued imatinib therapy and 20 patients early switched to nilotinib therapy.
  
  
  RESULTS
  Compared to continued imatinib group, nilotinib group showed significantly higher percentage achieving BCR-ABL1 <1% at 6 months (85.0% vs. 19.2%, P = 0.0004), better cumulative rates of MR3.0 and MR4.0 of 4 years (82.1% vs. 41.2%, P = 0.0091; 61.5% vs. 18.6%, P = 0.035).
  
  
  CONCLUSIONS
  In summary, early switching to nilotinib enabled more CML-CP patients with warning molecular response at 3 months to achieve early and deeper molecular response vs. remaining on imatinib.
authors.affiliation: a Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health , The First Affiliated Hospital of Soochow University , Suzhou , PR China.
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Yue
authors.affiliation: a Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health , The First Affiliated Hospital of Soochow University , Suzhou , PR China.
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Gui
authors.affiliation: a Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health , The First Affiliated Hospital of Soochow University , Suzhou , PR China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: He
authors.affiliation: a Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health , The First Affiliated Hospital of Soochow University , Suzhou , PR China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: a Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health , The First Affiliated Hospital of Soochow University , Suzhou , PR China.
authors.forename: Jinlan
authors.initials: J
authors.lastname: Pan
authors.affiliation: a Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health , The First Affiliated Hospital of Soochow University , Suzhou , PR China.
authors.forename: Huiying
authors.initials: H
authors.lastname: Qiu
authors.affiliation: a Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health , The First Affiliated Hospital of Soochow University , Suzhou , PR China.
authors.forename: Depei
authors.initials: D
authors.lastname: Wu
authors.affiliation: a Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health , The First Affiliated Hospital of Soochow University , Suzhou , PR China.|c Collaborative Innovation Center of Hematology , Soochow University , Suzhou , PR China.
authors.forename: Suning
authors.initials: S
authors.lastname: Chen
authors.affiliation: b Department of Pathology , The First Affiliated Hospital of Soochow University , Suzhou , PR China.
authors.forename: Lingchuan
authors.initials: L
authors.lastname: Guo
authors.affiliation: a Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health , The First Affiliated Hospital of Soochow University , Suzhou , PR China.
authors.forename: Jiannong
authors.initials: J
authors.lastname: Cen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D016044:Fusion Proteins, bcr-abl / Q000378:metabolism*; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage / Q000009:adverse effects; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000008:administration & dosage*; D013997:Time Factors
chemical_list: C581634:BCR-ABL1 fusion protein, human; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D016044:Fusion Proteins, bcr-abl; C498826:nilotinib
keywords: Chronic myeloid leukemia in chronic phase; Imatinib; Nilotinib