ArticleAmerican journal of hematology2013
Significance of deeper molecular responses in patients with chronic myeloid leukemia in early chronic phase treated with tyrosine kinase inhibitors.
Article in American journal of hematology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02852486 (Pilot Study of Imatinib Discontinuation in Patients With Chronic Myeloid Leukemia With Deep Molecular Response - Evaluation of Pioglitazone in Treatment-free Remission), which is not on this map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pilot Study of Imatinib Discontinuation in Patients With Chronic Myeloid Leukemia With Deep Molecular Response - Evaluation of Pioglitazone in Treatment-free Remission (EDI-PIO)
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Discontinuation of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia With Losing Major Molecular Response as a Definition for Molecular Relapse: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2019Pooled it
- Efficacy and safety of switching to nilotinib in patients with CML-CP in major molecular response to imatinib: results of a multicenter phase II trial (NILSw trial).International journal of hematology · 2018Trial
- Defining therapy goals for major molecular remission in chronic myeloid leukemia: results of the randomized CML Study IV.Leukemia · 2018Trial
- NKG2D gene polymorphisms are associated with disease control of chronic myeloid leukemia by dasatinib.International journal of hematology · 2017Trial
- Dasatinib rapidly induces deep molecular response in chronic-phase chronic myeloid leukemia patients who achieved major molecular response with detectable levels of BCR-ABL1 transcripts by imatinib therapy.International journal of clinical oncology · 2017Trial
- Impact of age on efficacy and toxicity of nilotinib in patients with chronic myeloid leukemia in chronic phase: ENEST1st subanalysis.Journal of cancer research and clinical oncology · 2017Trial
- Frontline nilotinib in patients with chronic myeloid leukemia in chronic phase: results from the European ENEST1st study.Leukemia · 2016Trial
- Safety and efficacy of imatinib in CML over a period of 10 years: data from the randomized CML-study IV.Leukemia · 2015Trial
- Article
- Article
- Leukemia Stem Cells as a Potential Target to Achieve Therapy-Free Remission in Chronic Myeloid Leukemia.Cancers · 2021Review
- Treatment-Free Remission in Chronic Myeloid Leukemia: Can We Identify Prognostic Factors?Cancers · 2021Review
- Targeting Leukemic Stem Cells in Chronic Myeloid Leukemia: Is It Worth the Effort?International journal of molecular sciences · 2021Review
- Treatment-free remission in patients with chronic myeloid leukaemia.Nature reviews. Clinical oncology · 2020Review
- Treatment and monitoring of Philadelphia chromosome-positive leukemia patients: recent advances and remaining challenges.Journal of hematology & oncology · 2019Review
- Tyrosine kinase inhibitor discontinuation in patients with chronic myeloid leukemia: a single-institution experience.Journal of hematology & oncology · 2019Article
- A second-generation TKI should always be used as initial therapy for CML.Blood advances · 2018Article
- Chronic Myeloproliferative Neoplasms: Some Remaining Challenges.HemaSphere · 2018Article
- Tyrosine kinase inhibitors in chronic myeloid leukaemia: which, when, for whom?Nature reviews. Clinical oncology · 2017Review
- Differential depth of treatment response required for optimal outcome in patients with blast phase versus chronic phase of chronic myeloid leukemia.Blood cancer journal · 2017Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
Most patients with chronic myeloid leukemia (CML) in chronic phase (CP) treated with tyrosine kinase inhibitors (TKI) achieve complete cytogenetic response (CCyR). An increasing number of patients also achieve deep molecular responses (MR). We determined the frequency and significance of deep MR after TKI therapy for CML in CP. MR included: major molecular response (MMR), MR4, MR4.5, and undetectable transcripts (UND), i.e., BCR-ABL/ABL of ≤0.1, ≤0.01, ≤0.0032%, and undetectable transcripts, respectively. Four hundred eighty-three patients received imatinib 400 mg/day (IM400, 71, July 2000 to April 2001), imatinib 800 mg/day (IM800, 204, June 2001 to July 2005), nilotinib (106, July 2005 to date), or dasatinib (102, November 2005 to date). UND rates at 36 months were 18.1, 30.6, 29.2, and 28.6%, respectively. Patients achieving UND have superior transformation-free survival (TFS) and overall survival (OS) versus those obtaining ≤MMR, but not other MR levels. At the 18- and 24-month landmark analysis, patients achieving UND have no advantage in TFS and OS compared to those achieving a lesser degree of MR. Among patients achieving MR4.5, those who maintain it for ≥2 years (susMR4·5) have no additional benefit in TFS or OS. Most patients with early CP CML receiving TKI achieve MMR. BCR-ABL transcripts become undetectable in a significant fraction of them. Deeper MR at 18 or 24 months are not associated with a benefit in TFS or OS. Furthermore, achieving susMR4·5 does not appear to further reduce the risk of transformation or death.
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