Outcomes of Chronic Myeloid Leukemia Patients With Early Molecular Response at 3 and 6 Months: A Comparative Analysis of Generic Imatinib and Glivec

被引:18
|
作者
Eskazan, Ahmet Emre [1 ]
Sadri, Sevil [1 ]
Keskin, Dilek [1 ]
Ayer, Mesut [2 ]
Kantarcioglu, Bulent [3 ]
Demirel, Naciye [3 ]
Aydin, Demet [3 ]
Aydinli, Fuat [4 ]
Yokus, Osman [4 ]
Ozunal, Isil Erdogan [1 ]
Berk, Selin [1 ]
Yalniz, Fevzi Firat [1 ]
Elverdi, Tugrul [1 ]
Salihoglu, Ayse [1 ]
Ar, Muhlis Cem [1 ]
Ongoren, Seniz [1 ]
Baslar, Zafer [1 ]
Aydin, Yildiz [1 ]
Tuzuner, Nukhet [5 ]
Ozbek, Ugur [6 ]
Soysal, Teoman [1 ]
机构
[1] Istanbul Univ, Cerrahpasa Fac Med, Dept Internal Med, Div Hematol, Istanbul, Turkey
[2] Haseki Training & Res Hosp, Dept Hematol, Istanbul, Turkey
[3] Okmeydani Training & Res Hosp, Dept Hematol, Istanbul, Turkey
[4] Istanbul Training & Res Hosp, Dept Hematol, Istanbul, Turkey
[5] Istanbul Univ, Cerrahpasa Fac Med, Dept Pathol, Istanbul, Turkey
[6] Istanbul Univ, Inst Expt Med DETAE, Dept Genet, Istanbul, Turkey
来源
CLINICAL LYMPHOMA MYELOMA & LEUKEMIA | 2017年 / 17卷 / 12期
关键词
BCR-ABL1; CML; Generic imatinib; Outcome; Response; CHRONIC PHASE; MANAGEMENT; MESYLATE; CML;
D O I
10.1016/j.clml.2017.07.255
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
We retrospectively evaluated 90 patients with chronic myeloid leukemia receiving either upfront original imatinib (Ol) or generic imatinib (Gl) for the effect of the early molecular response on the long-term outcome. We demonstrated that achieving an optimal response at 3 and 6 months in patients receiving either first-line Gl or Ol was clearly associated with greater response and event-free survival rates. Background: The molecular response at 3 months of the original imatinib (Ol) in patients with chronic myeloid leukemia has prognostic significance; however, this has never been tested for generic imatinib (Gl). Patients and Methods: We evaluated the BCR-ABL1 [international reporting scale (IS)] transcript levels at 3 and 6 months to determine whether an early molecular response (EMR) had a prognostic effect on the outcome among chronic myeloid leukemia patients receiving Gl. Ninety patients were divided into 2 groups, according to the imatinib they received, as Ol (group A) and Gl (group B). Results: Two groups were equally balanced for age, gender, Sokal risk score, and optimal response. The 2 groups did not differ in achieving an EMR at 3 months, and patients with EMR at 3 months had significantly superior complete cytogenetic response and major molecular response rates compared with patients who did not achieve an EMR in both groups. The percentage of an optimal response [BCR-ABL1 (IS), < 1%] and a warning response [BCR-ABL1 (IS), 1%-10%] at 6 months was 93% and 95% for groups A and B, respectively (P = .553). Patients with an optimal response (OR) at both 3 and 6 months had significantly superior event-free survival rates compared with patients without an OR in groups A and B. Conclusion: The results of the present study have demonstrated most probably for the first time that an OR at 3 and 6 months in patients receiving either first-line Gl and Ol is clearly associated with greater response and event-free survival rates. Prospective randomized trials with larger numbers of patients and longer follow-up periods are needed to address the effect of EMR in patients receiving Gl.
引用
收藏
页码:804 / 811
页数:8
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