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Blood, 1 June 2006, Vol. 107, No. 11, pp. 4250-4256. Prepublished online as a Blood First Edition Paper on February 7, 2006; DOI 10.1182/blood-2005-11-4406. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-11-4406v1 107/11/4250    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Press, R. D. Articles by Druker, B. J. Search for Related Content PubMed PubMed Citation Articles by Press, R. D. Articles by Druker, B. J. Related Collections Neoplasia Oncogenes and Tumor Suppressors Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS BCR-ABL mRNA levels at and after the time of a complete cytogenetic response (CCR) predict the duration of CCR in imatinib mesylate–treated patients with CML Richard D. Press, Zac Love, Ashlie A. Tronnes, Rui Yang, Thuan Tran, Solange Mongoue-Tchokote, Motomi Mori, Michael J. Mauro, Michael W. Deininger, and Brian J. Druker From the Department of Pathology; the Biostatistics Shared Resource, Cancer Institute; the Center for Hematologic Malignancies, Cancer Institute; and the Howard Hughes Medical Institute, Oregon Health & Science University, Portland. Although most patients with chronic myeloid leukemia (CML) treated with imatinib mesylate achieve a complete cytogenetic response (CCR), some patients will relapse. To determine the potential of real-time quantitative BCR-ABL reverse transcriptase–polymerase chain reaction (RT-PCR) to predict the duration of continued CCR, we monitored 85 patients treated with imatinib mesylate who achieved a CCR. With a median follow-up of 13 months after CCR (29 months after imatinib mesylate; median 6 RQ-PCR assays), 23 patients (27%) had disease progression (predominantly loss of CCR). Compared with the median baseline level of BCR-ABL mRNA, 42% of patients achieved at least a 2-log molecular response at the time of first reaching CCR. Failure to achieve a 2-log response at the time of CCR was an independent predictive marker of subsequent progression-free survival (hazard ratio = 5.8; 95% CI, 1.7-20; P = .005). After CCR, BCR-ABL mRNA levels progressively declined for at least the next 15 months, and 42 patients (49%) ultimately achieved at least a 3-log reduction in BCR-ABL mRNA. Patients failing to achieve this 3-log response, at any time during therapy, had significantly shorter progression-free survival (hazard ratio = 8.1; 95% CI, 3.1-22; P < .001). The achievement of either a 2-log molecular response at the time of CCR or a 3-log response anytime thereafter is a significant and independent prognostic marker of subsequent progression-free survival. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J. Laudadio, M. W.N. Deininger, M. J. Mauro, B. J. Druker, and R. D. Press An Intron-Derived Insertion/Truncation Mutation in the BCR-ABL Kinase Domain in Chronic Myeloid Leukemia Patients Undergoing Kinase Inhibitor Therapy J. Mol. Diagn., March 1, 2008; 10(2): 177 - 180. [Abstract] [Full Text] [PDF] H. Kantarjian, C. Schiffer, D. Jones, and J. Cortes Monitoring the response and course of chronic myeloid leukemia in the modern era of BCR-ABL tyrosine kinase inhibitors: practical advice on the use and interpretation of monitoring methods Blood, February 15, 2008; 111(4): 1774 - 1780. [Full Text] [PDF] R. D. Press, C. Galderisi, R. Yang, C. Rempfer, S. G. Willis, M. J. Mauro, B. J. Druker, and M. W.N. Deininger A Half-Log Increase in BCR-ABL RNA Predicts a Higher Risk of Relapse in Patients with Chronic Myeloid Leukemia with an Imatinib-Induced Complete Cytogenetic Response Clin. Cancer Res., October 15, 2007; 13(20): 6136 - 6143. [Abstract] [Full Text] [PDF] Z. Jobbagy, R. van Atta, K. M. Murphy, J. R. Eshleman, and C. D. Gocke Evaluation of the Cepheid GeneXpert BCR-ABL Assay J. Mol. Diagn., April 1, 2007; 9(2): 220 - 227. [Abstract] [Full Text] [PDF] D. P. Kalogianni, V. Bravou, T. K. Christopoulos, P. C. Ioannou, and N. C. Zoumbos Dry-reagent disposable dipstick test for visual screening of seven leukemia-related chromosomal translocations Nucleic Acids Res., February 28, 2007; 35(4): e23 - e23. [Abstract] [Full Text] [PDF] W. Ma, R. Tseng, M. Gorre, I. Jilani, M. Keating, H. Kantarjian, J. Cortes, S. O'Brien, F. Giles, and M. Albitar Plasma RNA as an alternative to cells for monitoring molecular response in patients with chronic myeloid leukemia Haematologica, February 1, 2007; 92(2): 170 - 175. [Abstract] [Full Text] [PDF] S. Branford Chronic Myeloid Leukemia: Molecular Monitoring in Clinical Practice Hematology, January 1, 2007; 2007(1): 376 - 383. [Abstract] [Full Text] [PDF]

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