PURPOSE: The aim of this study was to evaluate the clinical relevance of increases in quantitative polymerase chain reaction (QPCR) levels in patients with chronic myelogenous leukemia (CML) who are in complete cytogenetic response (CGCR) on therapy. Patients with Philadelphia chromosome (Ph)-positive CML receiving tyrosine kinase inhibitors (TKIs) are frequently monitored for response by QPCR studies for minimal molecular disease. The clinical significance of increasing levels of QPCR in patients in CGCR is uncertain. PATIENTS AND METHODS: One hundred sixteen patients in durable CGCR, and on imatinib therapy for at least 18 months, had increases in QPCR levels (documented at least twice consecutively) as defined by literature reports. These were further analyzed by the achievement of major molecular response (MMR) defined as QPCR < or = 0.05%, as well as by the degree of increase in QPCR. RESULTS: Only 11 (9.5%) of 116 patients with increases in QPCR had CML progression; 10 of them were among 44 patients (23%) who either lost a MMR or never had a MMR, and had more than 1 log increase of QPCR. CONCLUSION: Most patients with increases in QPCR remain in CGCR. Patients who lose a MMR or never achieve a MMR, and have more than 1 log increase of QPCR, should be monitored more closely, and may be evaluated for mutations of BCR-ABL kinase domain and considered for investigational therapeutic interventions.
PURPOSE: The aim of this study was to evaluate the clinical relevance of increases in quantitative polymerase chain reaction (QPCR) levels in patients with chronic myelogenous leukemia (CML) who are in complete cytogenetic response (CGCR) on therapy. Patients with Philadelphia chromosome (Ph)-positive CML receiving tyrosine kinase inhibitors (TKIs) are frequently monitored for response by QPCR studies for minimal molecular disease. The clinical significance of increasing levels of QPCR in patients in CGCR is uncertain. PATIENTS AND METHODS: One hundred sixteen patients in durable CGCR, and on imatinib therapy for at least 18 months, had increases in QPCR levels (documented at least twice consecutively) as defined by literature reports. These were further analyzed by the achievement of major molecular response (MMR) defined as QPCR < or = 0.05%, as well as by the degree of increase in QPCR. RESULTS: Only 11 (9.5%) of 116 patients with increases in QPCR had CML progression; 10 of them were among 44 patients (23%) who either lost a MMR or never had a MMR, and had more than 1 log increase of QPCR. CONCLUSION: Most patients with increases in QPCR remain in CGCR. Patients who lose a MMR or never achieve a MMR, and have more than 1 log increase of QPCR, should be monitored more closely, and may be evaluated for mutations of BCR-ABL kinase domain and considered for investigational therapeutic interventions.
Authors: Susan Branford; John F Seymour; Andrew Grigg; Chris Arthur; Zbigniew Rudzki; Kevin Lynch; Timothy Hughes Journal: Clin Cancer Res Date: 2007-12-01 Impact factor: 12.531
Authors: Moshe Talpaz; Neil P Shah; Hagop Kantarjian; Nicholas Donato; John Nicoll; Ron Paquette; Jorge Cortes; Susan O'Brien; Claude Nicaise; Eric Bleickardt; M Anne Blackwood-Chirchir; Vishwanath Iyer; Tai-Tsang Chen; Fei Huang; Arthur P Decillis; Charles L Sawyers Journal: N Engl J Med Date: 2006-06-15 Impact factor: 91.245
Authors: Jorge Cortes; Moshe Talpaz; Susan O'Brien; Dan Jones; Rajyalakshmi Luthra; Jenny Shan; Francis Giles; Stefan Faderl; Srdan Verstovsek; Guillermo Garcia-Manero; Mary B Rios; Hagop Kantarjian Journal: Clin Cancer Res Date: 2005-05-01 Impact factor: 12.531
Authors: Michele Baccarani; Giuseppe Saglio; John Goldman; Andreas Hochhaus; Bengt Simonsson; Frederick Appelbaum; Jane Apperley; Francisco Cervantes; Jorge Cortes; Michael Deininger; Alois Gratwohl; François Guilhot; Mary Horowitz; Timothy Hughes; Hagop Kantarjian; Richard Larson; Dietger Niederwieser; Richard Silver; Rudiger Hehlmann Journal: Blood Date: 2006-05-18 Impact factor: 22.113
Authors: Brian J Druker; François Guilhot; Stephen G O'Brien; Insa Gathmann; Hagop Kantarjian; Norbert Gattermann; Michael W N Deininger; Richard T Silver; John M Goldman; Richard M Stone; Francisco Cervantes; Andreas Hochhaus; Bayard L Powell; Janice L Gabrilove; Philippe Rousselot; Josy Reiffers; Jan J Cornelissen; Timothy Hughes; Hermine Agis; Thomas Fischer; Gregor Verhoef; John Shepherd; Giuseppe Saglio; Alois Gratwohl; Johan L Nielsen; Jerald P Radich; Bengt Simonsson; Kerry Taylor; Michele Baccarani; Charlene So; Laurie Letvak; Richard A Larson Journal: N Engl J Med Date: 2006-12-07 Impact factor: 91.245
Authors: Richard D Press; Chad Galderisi; Rui Yang; Carole Rempfer; Stephanie G Willis; Michael J Mauro; Brian J Druker; Michael W N Deininger Journal: Clin Cancer Res Date: 2007-10-15 Impact factor: 12.531
Authors: Timothy Hughes; Michael Deininger; Andreas Hochhaus; Susan Branford; Jerald Radich; Jaspal Kaeda; Michele Baccarani; Jorge Cortes; Nicholas C P Cross; Brian J Druker; Jean Gabert; David Grimwade; Rüdiger Hehlmann; Suzanne Kamel-Reid; Jeffrey H Lipton; Janina Longtine; Giovanni Martinelli; Giuseppe Saglio; Simona Soverini; Wendy Stock; John M Goldman Journal: Blood Date: 2006-03-07 Impact factor: 22.113
Authors: Hagop Kantarjian; Francis Giles; Lydia Wunderle; Kapil Bhalla; Susan O'Brien; Barbara Wassmann; Chiaki Tanaka; Paul Manley; Patricia Rae; William Mietlowski; Kathy Bochinski; Andreas Hochhaus; James D Griffin; Dieter Hoelzer; Maher Albitar; Margaret Dugan; Jorge Cortes; Leila Alland; Oliver G Ottmann Journal: N Engl J Med Date: 2006-06-15 Impact factor: 91.245