Pavlovsky C, Fernández I, Pavlovsky MA, Sackmann F, Remaggi G, Pavlovsky S

Language: Spanish
References: 17
Page: 11-16
PDF size: 89.72 Kb.

ABSTRACT

Background: The prognostic of chronic myeloid leukemia (CML) patients has dramatically changed since the introduction of tirosine kinase inhibitors (TKI). Miniminal residual disease (MRD) monitoring by Real Time quantitative PCR (RQ-PCR) is at present a usefull tool for monitoring patients in the TKI Era.
Objetives: to evaluate CML patients follow-up under treatment with TKI in a specialized center. Evaluate MRD by RQ-PCR in complete cytogenetic remission patients (CCR) in chronic phase analyzing different variables with impact in the maintenance of mayor molecular response (MMR).
Material and Methods: CML patients treated in FUNDALEU were analyzed with the intention to evaluate follow-up and molecular monitoring results. Median age was 50 years, 87 patients received imatinib treatment, 60 (69%) as 1st lineand 27 (31%) 2ary to Interferon.
Results: From 87 patients followed, 86 (99%) obtained CCR. Seventy three (84%) continue under imatinib treatment, 12 (14%) changed to a 2nd generation TKI and 2 interrupted treatment. Patients in CCR 63/86 (73%) obtained stable MMR (BCR-ABL[IS] ‹0.1%). Not reaching a stable MMR determined a major risk for cytogenetic relapse (4% with no MMR vs 0% in MMR). Patients with sustained MMR showed a significative longer cytogenetic relapse free survival at 10 years (100% vs 65%, P=0.002) with no impact on overall survival. Obtaining a stable MMR through time is considered a prognostic factor that protects against cytogenetic relapse. Our population showed a cytogenetic relapse free survival of 95% at 10 years.
Conclusion: Molecular monitoring by RQ-PCR is at present the most important tool for CML patients follow-up that had obtained CCR. The 95% of the patients treated with imatinib continue in CCR. Obtaining a stable and sustained MMR showed to be a predictor for CCR durability.

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