Blood Journal
Leading the way in experimental and clinical research in hematology

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

  1. Pratap Neelakantan1,
  2. Gareth Gerrard1,
  3. Claire Lucas2,
  4. Dragana Milojkovic1,
  5. Philippa May1,
  6. Lihui Wang2,
  7. Christos Paliompeis1,
  8. Marco Bua1,
  9. Alistair Reid1,
  10. Katayoun Rezvani1,
  11. Stephen O'Brien3,
  12. Richard Clark2,
  13. John Goldman1, and
  14. David Marin1,*
  1. 1 Department of Haematology, Imperial College London, Hammersmith Hospital, London, United Kingdom;
  2. 2 Department of Haematology, Royal Liverpool University Hospital, Liverpool, United Kingdom;
  3. 3 Department of Haematology, Northern Institute for Cancer Research, Newcastle University, Newcastle, United Kingdom
  1. * Corresponding author; email: d.marin{at}

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


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. ( Identifier: NCT01460693)

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