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Title: Prognostic factors in treatment of chronic myeloid leukemia with tyrosine kinase inhibitors

Abstract:

The aim of the study was to identify prognostic factors determining achieving and maintaining complete cytogenetic remission (CCyR) and major molecular remission (MMR) during tyrosine kinase inhibitors (TKI) therapy, and to optimise CML therapy after first line TKI failure. The study included 138 patients with chronic phase (CP) or accelerated phase (AP) of CML. All enrolled patients were treated with imatinib (IM) 400mg/day for CP or 600 mg/day for AP. The analyzed factors included: time to complete hematologic remission, time to CCyR, time to MMR, BCR/ABL kinase domain mutations and additional cytogenetic abnormalities in Ph positive cells [ACA Ph(+)]. To estimate probability of CCyR and MMR the cumulative incidence analysis was used. Progression free survival was estimated by Kaplan-Meier analysis. A statisticaly significant correlation was observed between probability of CCyR and probability of MMR and time to CHR, time to imatinib introduction, phase of the disease and additional cytogenetic abnormalities. No correlation between probability of CCyR and probability of MMR and age, sex, Sokal and Hasford risk factors was observed. CHR in ≤ 8weeks after diagnosis predicts CCyR and MMR irrespective of treatment to CHR. Early introduction of imatinib increases probability of CCyR and MMR in 12 and 18 months respectively. CCyR after 6 months of imatinib increases probability of MMR. Treatment with higher dose of IM due to accelerated phase predicts better outcome when ACA Ph(+) at diagnosis and/or at least 10% of blasts in bone marrow or periferal blood at diagnosis were considered as AP criteria. Treatment switch to 2G TKI after first line IM treatment failure is proposed to be optimal treatment standard.

Level of degree:

2 - studia doktoranckie

Degree discipline:

onkologia ; hematologia

Degree grantor:

Wydział Lekarski

Promoter:

Aleksander B. Skotnicki

Date issued:

2009

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:931

Call number:

ZB-110916

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Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

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Last modified:

Sep 12, 2019

In our library since:

Nov 21, 2012

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All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/931

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ZB-110916 Sep 12, 2019
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