Abstract
Objective: To compare the differences of deep molecular response (DMR) rate and time of obtaining DMR between dasatinib treated patients with increased and normal levels of large granular lymphocytes (LGLs) in newly diagnosed or imatinib resistant/intolerant chronic myeloid leukemia (CML) patients with positive BCR-ABL fusion gene. Methods: LGLs in peripheral blood were counted by flow cytometry and BCR-ABL fusion gene transcriptional level was detected by real-time quantitative polymerase chain reaction in 25 CML patients before and 1, 3, 6, 9, 12, 15, 18 months after dasatinib treatment. The enrolled patients were classified into LGLs+ group and LGLs- group according to whether the LGL counts were increased or not. Results: Among the 25 patients investigated, LGLs in 15 cases (5/15, 60%) were increased. Five cases in LGL+ group obtained DMR (33.3%) which was significantly higher than that of LGL- group (33.3% vs 10 %, P < 0.05). The median time of obtaining DMR in LGLs+ group and LGLs- group were 12 and 15 months respectively. Conclusions: Increased LGLs can be used as an indicator of prognosis in CML patients with positive BCR-ABL fusion gene who treated with dasatinib.
Highlights
Chronic myeloid leukemia (CML), represented 15% of leukemia, was a malignant hematopoietic disease characterized by proliferation of immature granulocytes[1]
Studies have shown that the first generation TKIs imatinib could target BCR-ABL fusion gene and significantly improved progression free survival (PFS) and overall survival (OS) in CML patients[14,15]
Immune deficiency of T cells is common in CML patients, and the immune function of CML patients is closely related to the disease progression of CML
Summary
Chronic myeloid leukemia (CML), represented 15% of leukemia, was a malignant hematopoietic disease characterized by proliferation of immature granulocytes[1]. BCR-ABL fusion gene was positive in more than 95% CML patients[2]. The quantities of BCR-ABL fusion gene expression represented the load of leukemia cells in CML patients. Detection the quantities of BCR-ABL fusion gene could be used to evaluate the effect of treatment in CML patients. A variety of studies have shown that dasatinib, one of the second generation TKI agents, may improve the number of lymphocytes in peripheral blood in CML patients[4,5]. Previous studies have shown that CML patients with increased LGLs might have higher possibility of acquiring deep molecular response (DMR)[10,11]. Increased LGLs were regarded as a predictor of favorable treatment response in CML patients[5,12]. We analyzed the clinical data of 25 CML patients treated with dasatinib to explore the difference of DMR rate and time of obtaining DMR between dasatinib treated patients with increased and normal levels of LGLs in newly diagnosed or imatinib resistant/intolerant CML patients with positive BCR-ABL fusion gene
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