Korean J Intern Med.  2017 Jan;32(1):125-136. 10.3904/kjim.2015.187.

BCR-ABL₁ transcripts (MR(4.5)) at post-transplant 3 months as an early predictor for long-term outcomes in chronic myeloid leukemia

• Lee SE
• Choi SY
• Kim SH
• Song HY
• Yoo HL
• Lee MY
• Kang KH
• Hwang HJ
• Jang EJ
• Kim DW

• KMID: 2365987
• DOI: http://doi.org/10.3904/kjim.2015.187

Abstract

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 (MR(4.5)), 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 MR(4.5) at 3 months and found that MR(4.5) 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.

Keyword

Leukemia, myelogenous, chronic, BCR-ABL positive; Allogeneic stem cell transplantation; Post-transplant relapse

MeSH Terms

Allografts
Disease-Free Survival
Follow-Up Studies
Humans
Incidence
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*
Multivariate Analysis
Recurrence
Reverse Transcriptase Polymerase Chain Reaction
ROC Curve
Stem Cell Transplantation