f2-cln64_8p731: Kaplan-Meier estimates of major molecular remission (MMR) according to the time interval elapsed between diagnosis and the initiation of imatinib therapy

Mentions: The patients who sustained MMR up to the thirtieth month of treatment started the use of imatinib about 14.4 months after the diagnosis (standard deviation [SD], 13.6 months) (Figure 3). The patients who achieved MMR showed a probability of maintaining MMR after 30 months of therapy of 80% if they received early treatment with imatinib. On the other hand, this probability was only 44% for patients who received late treatment (P=0.0005) (Figure 2).

Scerni AC, Alvares LA, Beltrão AC, Bentes IR, Azevedo TC, Bentes AQ, Lemos JA - Clinics (Sao Paulo) (2009)

Bottom Line: BCR-ABL transcript levels were measured at approximately six-month intervals using quantitative polymerase chain reaction.The early treatment group presented a 60% probability of achieving MMR, while the probability for those patients who received late treatment was 40%.The probability of either not achieving MMR within one year of the initiation of imatinib therapy or losing MMR was higher in patients who received late treatment (79%), compared with patients who received early treatment (21%, odds ratio=5.75, P=0.012).The probability of maintaining MMR at 30 months of treatment was 80% in the early treatment group and 44% in the late treatment group (P=0.0005).For CML patients in the chronic phase who were treated with second-line imatinib therapy, the probability of achieving and maintaining MMR was higher in patients who received early treatment compared with those patients for whom the time interval between diagnosis and initiation of imatinib therapy was longer than one year.

Affiliation: Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém/PA, Brazil.

Abstract: In Brazil, patients with chronic myeloid leukemia (CML) in the chronic phase were not given first-line imatinib treatment until 2008. Therefore, there was a long period of time between diagnosis and the initiation of imatinib therapy for many patients. This study aims to compare the major molecular remission (MMR) rates of early versus late imatinib therapy in chronic phase CML patients.Between May 2002 and November 2007, 44 patients with chronic phase CML were treated with second-line imatinib therapy at the Hematology Unit of the Ophir Loyola Hospital (Belém, Pará, Brazil). BCR-ABL transcript levels were measured at approximately six-month intervals using quantitative polymerase chain reaction.The early treatment group presented a 60% probability of achieving MMR, while the probability for those patients who received late treatment was 40%. The probability of either not achieving MMR within one year of the initiation of imatinib therapy or losing MMR was higher in patients who received late treatment (79%), compared with patients who received early treatment (21%, odds ratio=5.75, P=0.012). The probability of maintaining MMR at 30 months of treatment was 80% in the early treatment group and 44% in the late treatment group (P=0.0005).For CML patients in the chronic phase who were treated with second-line imatinib therapy, the probability of achieving and maintaining MMR was higher in patients who received early treatment compared with those patients for whom the time interval between diagnosis and initiation of imatinib therapy was longer than one year.