Treatment of philadelphia-positive chronic myeloid leukemia with imatinib: Importance of a stable molecular response

Francesca Palandri, Ilaria Lacobucci, Simona Soverini, Fausto Castagnetti, Angela Poerio, Nicoletta Testoni, Giuliana Alimena, Massimo Breccia, Giovanna Rege-Cambrin, Mario Tiribelli, Riccardo Varaldo, Elisabetta Abruzzese, Bruno Martino, Luigiana Luciano, Fabrizio Pane, Giuseppe Saglio, Giovanni Martinelli, Michele Baccarani, Gianantonio Rosti

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The achievement of a major molecular response (MMolR) at 12 months is a surrogate marker of progression-free survival in chronic myeloid leukemia patients treated with imatinib. Experimental Design: We evaluated the prognostic value of the long-term evolution of the molecular response based on a retrospective analysis of 130 late chronic phase chronic myeloid leukemia patients who achieved a complete cytogenetic response (CCgR) with 400 mg/d imatinib and have now a median follow-up of 72 months (range, 48-77). Results: In 71 (55%) patients, molecular response was consistently major (stable MMolR); in 19 (15%) patients, molecular response was occasionally less than major (unstable MMolR); in 40 (30%) patients, MMolR was never achieved (never MMolR) during all the course of CCgR. Patients with stable MMolR had a longer CCgR duration and a significantly better progression- free survival compared with patients with absent or unstable MMolR. The achievement of a MMolR, if maintained continuously, conferred a marked long-term stability to the CCgR: patients with a stable MMol R have a significantly lower risk of losing the CCgR than patients with unstable and never MMolR (4% versus 21%, P = 0.03, and 4% versus 33%, P <0.0001, respectively). Finally, if a MMolR is not maintained consistently, the risk of losing the CCgR is higher but not significantly than if it is never achieved (33% versus 21%, P = 0.5). Conclusions: These data confirm that achieving a MMolR is prognostically important but point out that the prognostic value of achieving a MMolR is greater if the response is confirmed and stable.

Original languageEnglish
Pages (from-to)1059-1063
Number of pages5
JournalClinical Cancer Research
Volume15
Issue number3
DOIs
Publication statusPublished - Feb 1 2009

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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