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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

邮发代号 80-967

2019 Impact Factor: 3.421

Frontiers of Medicine  2012, Vol. 6 Issue (2): 204-211   https://doi.org/10.1007/s11684-012-0202-x
  RESEARCH ARTICLE 本期目录
Prognostic analysis of chronic myeloid leukemia in Chinese population in an imatinib era
Prognostic analysis of chronic myeloid leukemia in Chinese population in an imatinib era
Haiyan He, Yang Shen, Yongmei Zhu, Saijuan Chen()
Shanghai Institute of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Abstract

We evaluated the outcomes of chronic myeloid leukemia (CML) patients in three clinical phases, namely, chronic (CP), accelerated (AP), and blast (BP) phases, receiving imatinib treatment. The single-institution treatment experiences of Chinese patients with CML were presented. A total of 275 CML patients (CP, 210; AP, 24; and BP, 41) who received imatinib between February 2001 and April 2008 were enrolled in this study. We evaluated the responses (hematologic, cytogenetic, and molecular), overall survival (OS), treatment event-free survival (EFS), and prognostic factors of outcome. At the cut-off point, the complete cytogenetic response (CCyR) and complete molecular response rates of patients in the CP were 84.7% and 61.9%, respectively, which were significantly higher than those of patients in the AP (50% and 29.1%, respectively, both P<0.001) and BP (24.3% and 9.7%, respectively, both P<0.001). The estimated five-year OS and five-year EFS rates were 93.2% and 86.4% for CP patients, as well as 64.5% and 50.9% for AP patients, which were significantly higher than those for BP patients (P<0.001). In CP patients, univariate analysis revealed that early treatment with imatinib, achieving CCyR within 12 months, additional cytogenetic abnormalities, and kinase domain mutations were associated with the treatment outcome. More patients are needed to carry out multivariate analysis.

Key wordsimatinib    chronic myeloid leukemia    complete cytogenetic response
收稿日期: 2012-03-30      出版日期: 2012-06-05
Corresponding Author(s): Chen Saijuan,Email:sjchen@stn.sh.cn   
 引用本文:   
. Prognostic analysis of chronic myeloid leukemia in Chinese population in an imatinib era[J]. Frontiers of Medicine, 2012, 6(2): 204-211.
Haiyan He, Yang Shen, Yongmei Zhu, Saijuan Chen. Prognostic analysis of chronic myeloid leukemia in Chinese population in an imatinib era. Front Med, 2012, 6(2): 204-211.
 链接本文:  
https://academic.hep.com.cn/fmd/CN/10.1007/s11684-012-0202-x
https://academic.hep.com.cn/fmd/CN/Y2012/V6/I2/204
Characteristics
Gender, no. of patients (%)MaleFemale156 (56.7)119 (43.3)
Mean age, yearsRange41.5±16.916-80
Clinical phase, no. of patients (%)CPAPBP210 (76.4)24 (8.7)41 (14.9)
Time interval between diagnosis and imatinib initiation, monthsMedianRange60-144
Patients with ACAs*, only for CP patients, no. of patients (%)PretreatmentAcquired during treatment45 (21.4)20 (9.5)25 (11.9)
Tab.1  
GroupsnCHRMCyRCcyRCMoR
CPAPBP2102441210 (100)23 (95.8)26 (63.4)188 (89.5)12 (50)11 (26.8)178 (84.7)12 (50)10 (24.3)130 (61.9)7 (29.1)4 (9.7)
P value&lt;0.001&lt;0.001&lt;0.001&lt;0.001
Tab.2  
Fig.1  
Fig.2  
Fig.3  
Fig.4  
ACAs acquired pretreatmentnACAs acquired during treatmentn
t(9; 11; 22), t(12;17)t(1; 9; 22)t(2; 9 ; 22)t(7; 9; 22)i(17q), +22, 2Ph1t(4; 16)t(1; 3) +8 +M9q+i(17q)22q+20q+1211111133221t(9; 16; 22)t(9; 20; 22)t(9; 17) +8, t(1;10) +M, 2Ph12Ph1 +8 +M-Y-21 +22 +8, i(17q)i(17q)9q+12p-der221111123521112111
Tab.3  
Fig.5  
PatientsPatient status whenmutations were detectedMonths afterimatinib initiationMutationsOutcome at the last follow-up
CP (1-12)123456789101112CHRCHRCHRCHRCHRCHRCHRPCyRLoss of CCyR-progress to BPProgress to APProgress to BPProgress to BP24181661218162418-25124812F359IM244VT315IG250EG250HG250ET315IG250EM244V/*F317L-*P441L/F317LT315IE255KE255KTherapy changeProgress to APNo CCyRTherapy changeDeathNo CCyRNo CCyRNo CCyRDeathDeathTherapy changeTherapy change
AP (13-15)131415CHRCHRProgress to BP afterachieving CCyR7126F359VE459KE459KTherapy changeTherapy changeDeath
BP (16-21)161718192021CHRCHRCHRCHRCHR-CHR-progress to BPProgress to BP afterachieving CCyR62236-18-2430E459KF359VL324QT315IT315I-F359I-Y253HL273MDeathDeathDeathDeathDeathDeath
Tab.4  
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