Abstract
Survival was cardinally increased after introducing Imatinib into the first line of therapy of chronic myeloid leukemia (CML) in children. However primary or second resistance was observed in 20–30 % of patients. For the purpose of detection of prognostic factors, a minimal residual disease was monitored in 22 patients at an age of 0–17 years. Furthermore, different variants of BCR/ABL transcript were identified. The results showed that patients with an early major molecular response and a b3a2 variant of the BCR/ABL transcript had significantly better results of treatment. In conclusion, a regular monitoring of a deep molecular response and a further correction of therapy allowed one to increase long-term overall survival in children with CML.
Highlights
Significance of deeper molecular responses in patients with chronic myeloid leukemia in early chronic phase treated with tyrosine kinase inhibitors / L
Management and clinical outcome of chronic myeloid leukemia (CML) patients after imatinib resistance associated with ABL kinase domain mutations / S
Correlation of BCR/ABL transcript variants with patients characteristics in childhood chronic myeloid leukaemia / R
Summary
Для сравнения выживаемости в группах использовали Log-rank критерий. При сравнении групп пациентов по качественным признакам использовали критерий χ2-квадрат. На фоне терапии иматинибом в первой линии ПГО достигнут у 22 (100 %) пациентов к 3-му месяцу терапии, к 6-му месяцу у одного из них произошла потеря ПГО с дальнейшим развитием бластного криза. ПЦО наблюдался у 15 (75,0 %) пациентов к 12 мес. Через 2 года у 14 (70,0 %) пациентов констатирован БМО Время его наступления на протяжении всего периода наблюдения у 82 % пациентов варьировалось от 6 до 48 мес. Что, несмотря на длительный период времени от момента наступления ПЦО до БМО, ни у одного из пациентов не отмечалось потери цитогенетического ответа. В течение всего периода наблюдения ПМО достигнут у 9 (43,0 %) пациентов. При этом сроки его достижения (молекулярная ремиссия) варьировались от 24 до 108 мес.
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