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KMID : 0338420170320010125
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The Korean Journal of Internal Medicine
2017 Volume.32 No. 1 p.125 ~ p.136
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BCR-ABL1 transcripts (MR4.5) at post-transplant 3 months as an early predictor for long-term outcomes in chronic myeloid leukemia
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Lee Sung-Eun
Choi Soo-Young
Kim Soo-Hyun
Song Hye-Young
Yoo Hea-Lyun
Lee Mi-Young
Kang Ki-Hoon
Hwang Hee-Jeong
Jang Eun-Jung
Kim Dong-Wook
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Abstract
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Background/Aims: The aim of this study was to identify the role of BCR-ABL1 transcript level as a predictor for post-transplant relapse and outcome in patients who underwent allogeneic stem cell transplantation (SCT) for chronic phase (CP) chronic myeloid leukemia (CML).
Methods: Of 101 patients receiving allograft in CML CP, 85 had available quantitative reverse transcriptase polymerase chain reaction data at post-transplant 3 months. These patients were divided into two groups according to molecular response (MR4.5), defined as a BCR-ABL1 transcript level ≤ 0.0032% on the international scale, at 3 months based on receiver operating characteristic curve analysis of relapse.
Results: The 4-year overall survival and event-free survival (EFS) were 80.6% and 57.3%, respectively, and the cumulative incidence of relapse at 4 years was 29.6% after a median follow-up of 126.4 months. We performed multivariate analyses including potential variables to evaluate the early predictive role of MR4.5 at 3 months and found that MR4.5 at 3 months was associated with a higher EFS (p = 0.028) and showed a trend for a lower relapse rate (p = 0.089).
Conclusions: our results imply that frequent molecular monitoring and immune suppressive therapy modulation are required for patients without reduction of BCR-ABL1 transcripts to this level after SCT.
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KEYWORD
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Leukemia, myelogenous, chronic, BCR-ABL positive, Allogeneic stem cell transplantation, Post-transplant relapse
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