Defining therapy goals for major molecular remission in chronic myeloid leukemia: results of the randomized CML Study IV.

Saussele, Susanne; Hehlmann, Rüdiger; Fabarius, Alice; Jeromin, Sabine; Proetel, Ulrike; Rinaldetti, Sebastien; Kohlbrenner, Katharina; Einsele, Hermann; Falge, Christiane; Kanz, Lothar; Neubauer, Andreas; Kneba, Michael; Stegelmann, Frank; Pfreundschuh, Michael; Waller, Cornelius F; Oppliger Leibundgut, Elisabeth; Heim, Dominik; Krause, Stefan W; Hofmann, Wolf-Karsten; Hasford, Joerg; ... (2018). Defining therapy goals for major molecular remission in chronic myeloid leukemia: results of the randomized CML Study IV. Leukemia, 32(5), pp. 1222-1228. Nature Publishing Group 10.1038/s41375-018-0055-7

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Major molecular remission (MMR) is an important therapy goal in chronic myeloid leukemia (CML). So far, MMR is not a failure criterion according to ELN management recommendation leading to uncertainties when to change therapy in CML patients not reaching MMR after 12 months. At monthly landmarks, for different molecular remission status Hazard ratios (HR) were estimated for patients registered to CML study IV who were divided in a learning and a validation sample. The minimum HR for MMR was found at 2.5 years with 0.28 (compared to patients without remission). In the validation sample, a significant advantage for progression-free survival (PFS) for patients in MMR could be detected (p-value 0.007). The optimal time to predict PFS in patients with MMR could be validated in an independent sample at 2.5 years. With our model we provide a suggestion when to define lack of MMR as therapy failure and thus treatment change should be considered. The optimal response time for 1% BCR-ABL at about 12-15 months was confirmed and for deep molecular remission no specific time point was detected. Nevertheless, it was demonstrated that the earlier the MMR is achieved the higher is the chance to attain deep molecular response later.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Hämatologie (Erwachsene)

UniBE Contributor:

Oppliger Leibundgut, Elisabeth

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0887-6924

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

20 Aug 2018 15:25

Last Modified:

23 Oct 2019 09:09

Publisher DOI:

10.1038/s41375-018-0055-7

PubMed ID:

29479070

BORIS DOI:

10.7892/boris.119394

URI:

https://boris.unibe.ch/id/eprint/119394

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