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Combining BCR-ABL1 transcript levels at 3 and 6 months in chronic myeloid leukemia: implications for early intervention strategies

Pratap Neelakantan, Gareth Gerrard, Claire Lucas, Dragana Milojkovic, Philippa May, Lihui Wang, Christos Paliompeis, Marco Bua, Alistair Reid, Katayoun Rezvani, Stephen O'Brien, Richard Clark, John Goldman, David Marin

Key points

  • Response to TKI can be accurately establish by measuring the 3 months transcript level

  • The 6 months measurement adds very little useful information

Abstract

Several groups have shown that that the BCR-ABL1 transcript level measured at 3 or 6 months after starting treatment with tyrosine kinase inhibitors strongly predicts for clinical outcomes for CML patients. In this work we asked whether the prognostic value of the 3-month transcript level could be improved by combining the 3- and 6- month results. We classified patients treated with imatinib and patients treated with dasatinib according to their transcript levels at 3 months and 6 months. The patients who met the 3-month landmark but failed the 6-month one had outcomes identical to those of patients who met both landmarks whereas the patients who failed the first landmark but met the second one had prognoses similar to those who failed both landmarks. In summary early intervention strategies can be based robustly just on the transcript level at 3 months. (ClinicalTrials.gov Identifier: NCT01460693)

  • Submitted November 14, 2012.
  • Accepted January 22, 2013.