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Imatinib improves but may not fully reverse the poor prognosis of patients with CML with derivative chromosome 9 deletions

Lookup NU author(s): Dr John Byrne, Julie Freeman-Edward, Gavin Cuthbert, Dr Nicholas Bown

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Abstract

Deletions of the derivative chromosome 9 occur in a subset of patients with Philadelphia chromosome-positive chronic myeloid leukemia (CML) and are associated with a poor prognosis on standard drug therapy. However, it is currently unknown if the presence of deletions influences the response to imatinib, an Abi-specific tyrosine kinase inhibitor, that has recently shown excellent hematologic and cytogenetic responses in patients with CML. We, therefore, compared hematologic and cytogenetic responses with imatinib in 397 patients with CML, and survival and progression in 354 of these patients, according to deletion status and disease phase. We found no difference in survival between patients with and without deletions, contrasting with previous reports in cohorts with a lower proportion of patients treated with imatinib. However, the time to disease progression on imatinib treatment was significantly shorter for patients with deletions, both in chronic phase (P = .02) and advanced phases (P = .02). Moreover, both in chronic phase and more advanced phases of CML, hematologic and cytogenetic responses were uniformly lower in patients with deletions, with significant differences seen for hematologic response (P = .04), for major cytogenetic response (P = .008) in chronic phase, and for hematologic response in advanced phases (P = .007) of CML. This finding suggests that differences in survival may become apparent with longer follow-up. (C) 2003 by The American Society of Hematology.


Publication metadata

Author(s): Huntly BJP, Guilhot F, Reid AG, Vassiliou G, Hennig E, Franke C, Byrne J, Brizard A, Niederwieser D, Freeman-Edward J, Cuthbert G, Bown N, Clark RE, Nacheva EP, Green AR, Deininger MWN

Publication type: Article

Publication status: Published

Journal: Blood

Year: 2003

Volume: 102

Issue: 6

Pages: 2205-2212

ISSN (print): 0006-4971

ISSN (electronic): 1528-0020

Publisher: American Society of Hematology

URL: http://dx.doi.org/10.1182/blood-2002-09-2763

DOI: 10.1182/blood-2002-09-2763


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