The predictive value of early molecular response in chronic myeloid leukaemia patients treated with imatinib in a single real-world medical centre in a developing country

Bee, Ping Chong; Sekaran, Veera; Ng, Richard Rui Jie; Kweh, Ting Yi; Gan, Gin Gin

doi:10.11622/smedj.2016063

Cited by 6 publications

(4 citation statements)

References 22 publications

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“…Therefore, the timing of the screening might have influenced the time to response in our patients. Nevertheless, our study showed an improvement in cumulative MMR rates with imatinib compared with previous local studies (26,36). Patient-supported programmes, access to imatinib and regular patient education programmes may have contributed to this result.…”

Section: Discussioncontrasting

confidence: 61%

Comparison of Clinicopathological Parameters, and Treatment Responses in Younger and Older Chronic Myeloid Leukaemia Patients Treated with Imatinib

Kamarudin,

Palaniappan,

Raja Sabudin

et al. 2023

MJMHS

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Introduction: Differences in baseline characteristics and response to treatment in different age groups of patients with chronic myeloid leukaemia (CML) in resource-limited countries have not been extensively studied. We aimed to determine the differences in clinicopathological parameters at diagnosis and response to imatinib in adult CML patients with younger (under 60 years; YCML) and older (60 years and older; OCML) age treated at our institution from March 2001 to March 2021. Methods: A retrospective analysis of consecutive adult CML patients receiving imatinib was performed. Clinicopathological parameters and treatment response were reviewed and analysed using hospital medical records and electronic data reports. Results: The median age at diagnosis was 50 years. OCML patients (n=17) had significantly more comorbidities. The YCML group (n=50) generally had a palpable spleen >5cm from the costal margin, mild anaemia, hyperleukocytosis and thrombocytosis. A starting dose of 400 mg/day was observed in 84% of YCML and in 65% of OCML. Cumulative complete cytogenetic response was 50% in YCML versus 70.6% in OCML, p=0.158. OCML tended to have a higher percentage of major molecular response (MMR) (52.9% versus 32%) and a shorter time to MMR, 22 months (range 5-70) versus 35 months (range 8-53). OCML experienced more haematological and non-haematological treatment-related adverse events after imatinib therapy. Conclusion: Although OCML patients had more comorbidities and treatment intolerances, overall long-term treatment response was comparable to YCML. In OCML, a more personalised approach to initial and subsequent dosing of imatinib may be considered.

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Section: Discussioncontrasting

confidence: 61%

Comparison of Clinicopathological Parameters, and Treatment Responses in Younger and Older Chronic Myeloid Leukaemia Patients Treated with Imatinib

Kamarudin,

Palaniappan,

Raja Sabudin

et al. 2023

MJMHS

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“…7 Bee et al observed in their study that the mean age was 45.5 years with range from 30.8 to 56.2 years. 8 Etienne et al demonstrated the median age as 56 years with range from 17 to 89 years. 9 In this series it was observed that all (100.0%) patients had splenomegaly, 22 (73.3%) had anaemia and 12 (40.0%) had hepatomegaly.…”

Section: Discussionmentioning

confidence: 99%

“…Bee et al demonstrated that the BCR-ABL1 level at three months did not predict better OS (overall survival at ten years); patients who had a BCR-ABL1 level ≤10% did not have significantly better OS than those who had a BCR-ABL 1 level>10% at three months (100.0% vs. 95.2%, respectively; p:0.545). 8 Hughes et al consisted their study patients who achieved early molecular response (EMR) at 3 months were more likely to achieve major molecular response (MMR) by 2 years than were patients with EMR failure. 3 Quintas-Cardama et al showed that the patients with a BCR-ABL1/ABL1 ratio greater than 1% to 10% after 3 months of imatinib had a 92% probability of achieving CCyR with continued therapy, similar to the 98% for those with 1% or less, but their risk of progression (11%) was almost 3-fold that of patients with a BCR-ABL1/ABL1 transcript ratio of 1% or less (4%) and similar to that of patients with transcript levels more than 10% (13%).…”

Section: Discussionmentioning

confidence: 99%

Molecular Response of Chronic Myeloid Leukaemia Patients to Tyrosine Kinase Inhibitors

Hossain¹,

Yamani²,

Hossain³

et al. 2020

Haematol J Bangladesh

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Background: The goal of therapy in Chronic Myeloid Leukaemia (CML) with tyrosine kinase inhibitors (TKIs) has been to achieve the molecular responses, as measured by the reduction or elimination of BCR-ABLl transcript. Objective: The aim of the study is to observe the molecular response status of CML patients to TKIs. Methodology: This is an observational study and was conducted in the department of Haematology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from February 2018 to January 2019. A total of 30 diagnosed CML patients on TKIs therapy was checked for quantitative BCR-ABL1 (by qRT-PCR) level. The laboratory monitoring of BCR-ABL1 RNA with RQ-PCR was likely become the model for successful molecular diagnostic monitoring of CML patients to both assess and prognosticate the efficacy of these targeted treatments. Result: Among 30 diagnosed CML patients, the mean age was found 36.1±11.7 years with range from 20 to 70 years. Males were predominant 19 (63.3%), male: female ratio was 1.7:1. Almost two third (63.3%) patients were found optimal (?10%) after 3-month BCR ABL. Age, sex, religion, marital status, occupational status, BMI, monthly income, number of family member, symptoms and sings were not statistically significant (p>0.05) when compared between BCR ABL optimal (?10%) and warning (>10%) group. Mean haemoglobin, total leukocyte count, platelet count, basophil, myelocyte and baseline BCR ABL1 were not statistically significant (p>0.05) however atypical cells was found statistically significant (p

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“…Therefore, the BCR-ABL1 transcript level at 3 and 6 months after starting imatinib is used as a predictive marker. 8,[18][19][20][21][22][23][24][25][26][27] However, it is not clear if the same principle applies to the patient population from Iran. In light of the above, the study aims to investigate the molecular response to imatinib mesylate treatment in the population of patients with CML in Iran and to determine the association with OS and PFS in this population.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Molecular Response to Imatinib Mesylate Treatment in Iranian Patients With Chronic Myeloid Leukemia

Nekoohesh

Rostami

Nikbakht

et al. 2020

Clinical Lymphoma Myeloma and Leukemia

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The predictive value of early molecular response in chronic myeloid leukaemia patients treated with imatinib in a single real-world medical centre in a developing country

Cited by 6 publications

References 22 publications

Comparison of Clinicopathological Parameters, and Treatment Responses in Younger and Older Chronic Myeloid Leukaemia Patients Treated with Imatinib

Comparison of Clinicopathological Parameters, and Treatment Responses in Younger and Older Chronic Myeloid Leukaemia Patients Treated with Imatinib

Molecular Response of Chronic Myeloid Leukaemia Patients to Tyrosine Kinase Inhibitors

Evaluation of Molecular Response to Imatinib Mesylate Treatment in Iranian Patients With Chronic Myeloid Leukemia

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