open access

Ahead of print
Original research article
Published online: 2021-04-28
Submitted: 2021-01-14
Accepted: 2021-02-19
Get Citation

Deep molecular response on imatinib treatment — results from a real-life retrospective study

Aleksandra Gołos, Joanna Niesiobędzka-Krężel, Joanna Góra-Tybor
DOI: 10.5603/AHP.a2021.0027

open access

Ahead of print
ORIGINAL RESEARCH ARTICLE
Published online: 2021-04-28
Submitted: 2021-01-14
Accepted: 2021-02-19

Abstract

Introduction: Tyrosine kinase inhibitors (TKIs) have dramatically changed the outcome of chronic myeloid leukemia (CML) patients. Recent research focused on TKI discontinuation after achieving a deep molecular response (DMR) has revealed that about half of the patients maintain the response. DMR is a key criterion for TKI discontinuation. Our retrospective, ‘real-life’ study was aimed at to estimating the proportion of patients treated with first-line imatinib (IM) who achieved DMR and thus may be candidates for discontinuation of TKI treatment in a real life setting.

Material and methods: Two hundred and twenty-three patients were enrolled. All patients started IM at 400 mg daily. The median age at the time of diagnosis was 57 years (range: 17–92).

Results: Eighty-five patients (43%) in the whole group achieved DMR. Early molecular response (EMR) was achieved by 136 (69%) patients and correlated with the DMR rate (53% with EMR vs 14% without, p < 0.001). Major molecular response (MMR) after a year of treatment was confirmed in 108 (55%) patients, and was predictive for achieving DMR at any time (69% with MMR vs. 24% without, p < 0.001).

Conclusion: DMR can be achieved in a significant proportion of patients in a real-life setting. We observed that both the achievement of an EMR at three months and MMR at 12 months were associated with a significant advantage in terms of DMR.

Abstract

Introduction: Tyrosine kinase inhibitors (TKIs) have dramatically changed the outcome of chronic myeloid leukemia (CML) patients. Recent research focused on TKI discontinuation after achieving a deep molecular response (DMR) has revealed that about half of the patients maintain the response. DMR is a key criterion for TKI discontinuation. Our retrospective, ‘real-life’ study was aimed at to estimating the proportion of patients treated with first-line imatinib (IM) who achieved DMR and thus may be candidates for discontinuation of TKI treatment in a real life setting.

Material and methods: Two hundred and twenty-three patients were enrolled. All patients started IM at 400 mg daily. The median age at the time of diagnosis was 57 years (range: 17–92).

Results: Eighty-five patients (43%) in the whole group achieved DMR. Early molecular response (EMR) was achieved by 136 (69%) patients and correlated with the DMR rate (53% with EMR vs 14% without, p < 0.001). Major molecular response (MMR) after a year of treatment was confirmed in 108 (55%) patients, and was predictive for achieving DMR at any time (69% with MMR vs. 24% without, p < 0.001).

Conclusion: DMR can be achieved in a significant proportion of patients in a real-life setting. We observed that both the achievement of an EMR at three months and MMR at 12 months were associated with a significant advantage in terms of DMR.

Get Citation

Keywords

chronic myeloid leukemia; imatinib; deep molecular response

About this article
Title

Deep molecular response on imatinib treatment — results from a real-life retrospective study

Journal

Acta Haematologica Polonica

Issue

Ahead of print

Article type

Original research article

Published online

2021-04-28

DOI

10.5603/AHP.a2021.0027

Keywords

chronic myeloid leukemia
imatinib
deep molecular response

Authors

Aleksandra Gołos
Joanna Niesiobędzka-Krężel
Joanna Góra-Tybor

References (13)
  1. Kalmanti L, Saussele S, Lauseker M, et al. Safety and efficacy of imatinib in CML over a period of 10 years: data from the randomized CML-study IV. Leukemia. 2015; 29(5): 1123–1132.
  2. Hochhaus A, Larson R, Guilhot F, et al. Long-term outcomes of imatinib treatment for chronic myeloid leukemia. N Engl J Med. 2017; 376(10): 917–927.
  3. Jabbour E, Kantarjian HM, O'Brien S, et al. Front-line therapy with second-generation tyrosine kinase inhibitors in patients with early chronic phase chronic myeloid leukemia: what is the optimal response? J Clin Oncol. 2011; 29(32): 4260–4265.
  4. Hochhaus A, Baccarani M, Silver RT, et al. European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia. Leukemia. 2020; 34(4): 966–984.
  5. Jain P, Kantarjian H, Nazha A, et al. Early responses predict better outcomes in patients with newly diagnosed chronic myeloid leukemia: results with four tyrosine kinase inhibitor modalities. Blood. 2013; 121(24): 4867–4874.
  6. Etienne G, Guilhot J, Rea D, et al. Long-term follow-up of the french stop imatinib (STIM1) study in patients with chronic myeloid leukemia. J Clin Oncol. 2017; 35(3): 298–305.
  7. Saussele S, Richter J, Guilhot J, et al. EURO-SKI investigators. Discontinuation of tyrosine kinase inhibitor therapy in chronic myeloid leukaemia (EURO-SKI): a prespecified interim analysis of a prospective, multicentre, non-randomised, trial. Lancet Oncol. 2018; 19(6): 747–757.
  8. Hughes TP, Ross DM. Moving treatment-free remission into mainstream clinical practice in CML. Blood. 2016; 128(1): 17–23.
  9. Baccarani M, Deininger MW, Rosti G, et al. European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013. Blood. 2013; 122(6): 872–884.
  10. Nicolini FE, Alcazer V, Cony-Makhoul P, et al. Long-term follow-up of de novo chronic phase chronic myelogenous leukemia patients on front-line imatinib. Exp Hematol. 2018; 64: 97–105.e4.
  11. Castagnetti F, Di Raimondo F, De Vivo A, et al. A population-based study of chronic myeloid leukemia patients treated with imatinib in first line. Am J Hematol. 2017; 92(1): 82–87.
  12. Marin D, Ibrahim AR, Lucas C, et al. Assessment of BCR-ABL1 transcript levels at 3 months is the only requirement for predicting outcome for patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors. J Clin Oncol. 2012; 30(3): 232–238.
  13. Molica M, Colafigli G, Scalzulli E, et al. Ten-year outcome of chronic-phase chronic myeloid leukemia patients treated with imatinib in real life. Ann Hematol. 2019; 98(8): 1891–1904.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: journals@viamedica.pl