Putu Niken Ayu Amrita and Siprianus Ugroseno Yudho Bintoro (2020) Impact of molecular response time achievement on survival of chronic phase chronic myelogenous leukemia patients treated by imatinib. Drug Invention Today, 13 (6). pp. 863-867. ISSN 09757619

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Abstract

Background: Chronic myelogenous leukemia (CML) is the most common myeloproliferative disorder. BCR-ABL, the CML cell, contains oncogene makes tyrosine kinase protein which causes cells to grow and reproduce out of control. Recently, a tyrosine kinase inhibitor, namely, imatinib had high efficacy in CML treatment. Importantly, quantification of BCR-ABL transcripts is the most sensitive method to monitor molecular response at deeper levels than the hematologic and cytogenetic response to achieve an excellent outcome. Objective: We described the molecular response, time achievement, and the impact on survival in CML patients. Materials and Methods: A retrospective medical record of 143 BCR-ABL positive chronic phase CML patients have been treated by imatinib 400 mg. The hematological response was determined and the molecular response was assigned by BCR-ABL quantification. The time to achieve major molecular response (MMR) was defined by ≤0.10% ratio of BCR-ABL to ABL control gene and its impact on median survival. Results: In our study, the median age at presentation was 45 years (range 12–73 years). Male to female ratio was 2:1. Patients achieved MMR on 12, 18, and 24 months were 8 (5.5%), 26 (18.2%), and 26 (18.2%), respectively. Patients achieved MMR in <24 months have longer median survival 83.8 (77.4–90.8) months compared to 58.9 (51.7–66.2) of those who failed to achieve it in 24 months, P < 0.001. Conclusion: Our data have shown time to MMR achievement had an impact on survival. The patients that did not achieve MMR had a poorer clinical outcome. Early recognition and prompt treatment of these patients can improve outcomes.

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