RESUMEN
AIM: To reveal prognostically significant factors affecting efficacy of glivek therapy in untreated (duration of the disease < or = 6 months) and pretreated (duration of the disease > 6 months) patients with chronic myeloid leukemia (CML) in a chronic phase. MATERIAL AND METHODS: A total of 338 patients (64 untreated and 274 pretreated) with a chronic-phase CML on glivek therapy entered the trial. RESULTS: Five-year survival on glivek was high (89, 98 and 88% in untreated and pretreated patients, respectively). Incidence of transformation in the acceleration phase and blast crisis was low both in untreated and pretreated patients (1.6 and 11%, respectively) and correlated with the rate of a complete cytogenetic response (CCR). Untreated patients had no factors affecting treatment efficacy negatively, CCR probability was 96%. Blastemia, thrombocytosis and splenomegaly reduced CCR probability significantly in pretreated patients. Slow reduction of the tumor mass, late achievement of a complete hematological response and a cytogenetic response decreased probability of CCR. CONCLUSION: Glivek is a drug of choice for patients with chronic-phase CML. High probability of CCR both in untreated and pretreated patients lowers the risk of the disease transformation into the phase of acceleration/blast crisis and raises overall survival in both groups.
Asunto(s)
Antineoplásicos/uso terapéutico , Leucemia Mieloide de Fase Crónica/tratamiento farmacológico , Piperazinas/uso terapéutico , Pirimidinas/uso terapéutico , Adolescente , Adulto , Anciano , Benzamidas , Crisis Blástica/epidemiología , Crisis Blástica/patología , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Hematopoyesis/efectos de los fármacos , Humanos , Mesilato de Imatinib , Incidencia , Leucemia Mieloide de Fase Crónica/mortalidad , Leucemia Mieloide de Fase Crónica/patología , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Pronóstico , Proteínas Tirosina Quinasas/antagonistas & inhibidores , Factores de Riesgo , Federación de Rusia/epidemiología , Tasa de Supervivencia/tendencias , Factores de TiempoRESUMEN
Chronic myeloid leukemia (CML) is a hemopoietic condition caused by chromosomal translocation t(9;22)(q34;q11) or bcr-abl fusion gene. The predominant variants of bcr-abl oncogene rearrangement are b3a2 and b2a2. The present study evaluated the efficacy of interferon-a therapy of CML patients and molecular prognostic factors. Cytogenetic response and complete hematological remission were more frequent in CML b3a2 treatment with interferon-a. Moreover, after therapy, chronic phase lasted in that group (p = 0.026) much longer. Overall survival in the group was significantly longer, too (p = 0.046).
Asunto(s)
Antineoplásicos/uso terapéutico , Interferón-alfa/uso terapéutico , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Biomarcadores de Tumor/metabolismo , Humanos , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
The investigation deals with a simplified modification or molecular-genetic detection of translocation t(9;22) using a combination of reverse transcription and polymerase chain reactions (RT-PCR). Unlike the available protocols, analysis is carried out using one enzyme--TET-Z polymerase--(instead of two) which has both revertase and DNA-polymerase activities. The present modification is highly sensitive, less time-consuming and cheaper. The method has proved useful for both diagnosing t(9;22) translocation and diagnosing and monitoring minimal residual disease remaining after marrow transplantation.