TY  - JOUR
T1  - Molecular Response Assessment in Patients with Chronic Myeloid Leukemia; Clinicopathological Retrospective Research
AU  - Kaçar Döger, Füruzan
AU  - Erdoğdu, İbrahim Halil
AU  - Çırak Balta, Merve
AU  - Bolaman, Ali Zahit
AU  - Yavaşoğlu, İrfan
PY  - 2022
DA  - December
DO  - 10.4274/meandros.galenos.2022.63497
JF  - Meandros Medical And Dental Journal
JO  - Meandros Med. Den. j.
PB  - Aydin Adnan Menderes University
WT  - DergiPark
SN  - 2149-9063
SP  - 469
EP  - 474
VL  - 23
IS  - 4
LA  - en
AB  - Objective: Chronic myeloid leukemia (CML) is a stem cell disease caused by clonal increase of precursor cells. In the studies conducted, it is stated that followup of patients has positive effects on the prognosis. In this study, it is aimed to review the molecular response assessment used in the follow-up of CML patients by sharing the clinical-pathology experience and to review the literature. Materials and Methods: Seventy-six cases who underwent bone marrow biopsy samples assessment in Adnan Menderes University Faculty of Medicine Department of Pathology in 2018-2019 and clinically diagnosed as myeloproliferative neoplasia/ CML, followed by BCR-ABL analysis at the 3rd, 6th and 9th months. Results: Seventy-one (93.4%) of our cases were in chronic phase, 4 were in accelerated phase (5.3%) and 1 (1.3%) was in blastic phase. Major molecular response (MMR) was observed in 31 patients in the 3rd month (40.8%), 42 patients in the 6th month (55.3%) and 51 patients (67.1%) in the 9th month. The mean followup period of the patients was 20.5 months. During this period, uneventful survival was observed in 65 patients according to ELN criteria, death in 5 patients (6.6%) and relapse in 7 patients (7.9%). While the MMR observed in the early period was observed to be related to the patient’s life span (p≤0.05), it was not associated with relapse (p≥0.05). Conclusions: Achieving the MMR is important for prognosis. The importance of molecular monitoring, which is a more sensitive method for evaluating treatment effectiveness and monitoring the response, is increasing.
KW  - Chronic myeloid leukemia
KW  - major molecular
response
KW  - molecular follow-up
KW  - prognosis
CR  - 1. Swerdlaw SH, Campo E, Harris NC, Jaffe ES, Pileri SA, Stein H, et al. WHO Classification Tumors of hematopoietic and lymphoid tissues. France: IARC, 2017.
CR  - 2. Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 2016; 127: 2391-405.
CR  - 3. Aijaz J, Junaid N, Asif Naveed M, Maab R. Risk Stratification of Chronic Myeloid Leukemia According to Different Prognostic Scores. Cureus 2020; 20: e7342.
CR  - 4. Jabbour E, Kantarjian H. Chronic myeloid leukemia: 2018 update on diagnosis, therapy and monitoring. Am J Hematol 2018; 93: 442-59.
CR  - 5. Abu-Tineh M, Kassem N, Abdulla MA, Ismail OM, Obeidat K, Ghasoub R, et al. Outcome of Pregnancy in the Era of PEGylatedInterferon–α2a Females with Chronic Myeloid Leukemia: An experience from Qatar. Case Rep Oncol 2020; 13: 291-4.
CR  - 6. Geary CG. The story of chronic myeloid leukemia. Br J Haematol 2001; 112: 282-92.
CR  - 7. Rowley JD. Letter: a new consistent chromosomal abnormality in chronic myelogenous leukaemia identified by quinacrine fluorescence and Giemsa staining. Nature 1973; 243: 290-3.
CR  - 8. Faderl S, Talpaz M, Estrov Z, O Brien S, Kurzrock R, Kantarjian HM. The biology of chronic myeloid leukemia. N Engl J Med 1999; 341: 164-72.
CR  - 9. Quintás-Cardama A, Cortes J. Molecular biology of BCR-ABL1 – positive chronic myeloid leukemia. Blood 2009; 113: 1619-30.
CR  - 10. Ren R. Mechanisms of BCR-ABL1 in the pathogenesis of chronic myelogenous leukaemia. Nat Rev Cancer 2005; 5: 172-83.
CR  - 11. Muñoz JD, Barranco Lampón GI, Castellanos H, Ramos C, Zazueta JF. Philadelphia Chromosome-Positive De Novo Acute Myeloid Leukemia Treated with Chemotherapy and Second-Generation Tyrosine Kinase Inhibitor. Cureus 2019; 15: e5135.
CR  - 12. Abou Dalle I, Kantarjian HM, Short NJ, Konopleva M, Jain N, Garcia-Manero G, et al. Philadelphia chromosome-positive acute lymphoblastic leukemia at first relapse in the era of tyrosine kinase inhibitors. Am J Hematol 2019; 94: 1388-95.
CR  - 13. Hochhaus A, Larson RA, Guilhot F, Radich JP, Branford S, Hughes TP, et al. Long-term outcomes of imatinib treatment for chronic myeloid leukemia. N Engl J Med 2017; 376: 917-27.
CR  - 14. Zhang J, Wang Y, Wang J, Hu J, Chen S, Jin J, et al. Early BCR-ABL1 decline in imatinib-treated patients with chronic myeloid leukemia: results from a multicenter study of the Chinese CML alliance. Blood Cancer J 2018; 15: 61.
CR  - 15. Turkish Hematology Association. National CML Diagnosis and Treatment Guide 2016.
CR  - 16. Spiess B, Rinaldetti S, Naumann N, Galuschek N, Kossak-Roth U, Wuchter P, et al. Diagnostic performance of the molecular BCR-ABL1 monitoring system may impact on inclusion of CML patients in stopping trials. PLoS One 2019; 14: e0214305.
CR  - 17. Dulucq S, Etienne G, Morisset S, Klein E, Chollet C, Robbesyn F, et al. Impact of second decline rate of BCR-ABL1 transcript on clinical outcome of chronic phase chronic myeloid leukemia patients on imatinib first-line. Ann Hematol 2019; 98: 1159-68.
CR  - 18. Demirağ F. The scope and role of molecular pathology. Turkiye Klinikleri J Radiat Oncol-Special Topics 2016; 2: 70-5.
CR  - 19. Chereda B, Melo JV. Natural course and biology of CML. Ann Hematol 2015; 94 Suppl 2: S107-21.
CR  - 20. Hehlmann R, Hochhaus A, Baccarani M; European LeukemiaNet. Chronic myeloid leukaemia. Lancet 2007; 370: 342-50.
CR  - 21. Huang X, Cortes J, Kantarjian H. Estimations of the increasing prevalence and plateau prevalence of chronic myeloid leukemia in the era of tyrosine kinase inhibitor therapy. Cancer 2012; 118: 3123-7.
CR  - 22. Baccarani M, Deininger MW, Rosti G, Hochhaus A, Soverini S, Apperley JF, et al. European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013. Blood 2013; 122: 872-84.
CR  - 23. Brandford S, Yeung DT, Parker TW, Roberts ND, Purins L, Bralley JA, et al. Prognosis for Patients with CML and 10% BCR-ABL1 after 3 months of imatinib depends on BCR-ABL1 decline. Blood 2014: 24; 511-8.
CR  - 24. Cai Z, Jia X, Zi J, Song H, Wang S, McGrath M, et al. BCR-ABL1 transcript decline ratio combined BCR-ABL1 as a precise predictor or imatinib response and outcome in the patients with chronic myeloid leukemia. J Cancer 2020; 11: 2234-40.
CR  - 25. Braun TP, Eide CA, Druker BJ. Response and Resistance to BCR-ABL1-Targeted Therapies. Cancer Cell 2020; 37: 530-42.
UR  - https://doi.org/10.4274/meandros.galenos.2022.63497
L1  - https://dergipark.org.tr/en/download/article-file/4904519
ER  -