Chronic myeloid leukemia in chronic phase responding to imatinib: the occurrence of additional cytogenetic abnormalities predicts disease progression.

摘要: BACKGROUND AND OBJECTIVES: The acquisition of additional cytogenetic changes (clonal evolution, CE) during treatment chronic myeloid leukemia (CML) with imatinib mesylate is currently regarded as an index increasing resistance to imatinib. Therefore, investigate whether CE isolated event increases the risk disease progression treatment, we compared outcome patients CML in phase (CML-CP) who developed whilst complete hematologic remission comparable showed no evidence CE. DESIGN METHODS: We serially studied findings 102 receiving Abl-tyrosine kinase inhibitor, mesylate, sole agent treat CML-CP had before initiation treatment. RESULTS: was identified 15 patients, 10 whom were remission. In most cases these occurred exclusively Ph+ population but three a co-existing Ph-negative population. Patients de novo absence any other sign significantly higher incidence by 18 months than did non-CE (progression-free survival 34.3% (CI 10.5-69.8%) vs. 94.1% 80.6-98.4%), p<0.0001). INTERPRETATION CONCLUSIONS: Based on this relatively small series conclude that clonal evolution subsequent also