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



Nekoohesh L^{1, 2} ; Rostami S^{2, 3} ; Nikbakht M^{2, 3} ; Mohammadi S^{2, 3} ; Babakhani D^{2, 3} ; Alimoghaddam K^{2, 3} ; Ghahremani MH^{1, 4} ; Chahardouli B^{2, 3} Show Affiliations
Source: Clinical Lymphoma# Myeloma and Leukemia Published:2020

Abstract

Background: Imatinib mesylate has revolutionized the treatment of patients with chronic myeloid leukaemia (CML); however, some patients fail to respond and have a poor prognosis. Evaluation of molecular response to imatinib is a sensitive method can help physicians make better and quicker therapeutic decisions in the course of this disease. This study aims to evaluate the molecular response to generic imatinib in Iranian patients with CML. Patients and Methods: This prospective study consisted of 255 newly diagnosed patients with CML who received imatinib. Molecular response was analyzed at 3 and 6 months from the start of the treatment and then every 6 months, and long-term outcomes, including overall survival (OS) and progression-free survival (PFS), were evaluated. Results: At a median follow-up of 34.8 months (range, 3-84 months, (the OS and PFS at 7 years were 94.3% and 92.9%, respectively. Eighty–four-month PFS rates in patients with a BCR-ABLIS ≤ 10% at 3 months and BCR-ABLIS ≤ 1% at 6 months were significantly higher than patients who did not obtain these levels of BCR-ABL transcripts (P = .004 and P < .0001, respectively). The proportion of patients who achieved major molecular response (MMR) was 44.1%, 52.97%, and 60.75% at 12, 18, and 24 months, respectively. At 12, 18, and 84 months, the PFS rates in patients who achieved MMR were significantly higher than in patients who did not achieve MMR (P = .002, P < .0001, and P = .003, respectively). Conclusions: The data of this prospective study are highly comparable with that from clinical trials and prospective international studies. This study demonstrates that progression-free survival and overall survival were improved in Iranian patients with chronic phase chronic myeloid leukemia who achieved BCR-ABLIS ≤ 10% at 3months, BCR-ABLIS ≤ 1% at 6 months and major molecular response at 12 and 18 months. The data of this prospective study are highly comparable with clinical trials and prospective international studies and show that the evaluation of time-dependent molecular response to imatinib is a sensitive method that can help physicians make better and quicker therapeutic decisions in the course of this disease. © 2019 Elsevier Inc.