The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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BCR-ABL1 transcripts (MR4·5) at post-transplant 3 months as an early predictor for long-term outcomes in chronic myeloid leukemia

  • Lee, Sung-Eun (Catholic Leukemia Research Institute, The Catholic University of Korea) ;
  • Choi, Soo Young (Catholic Leukemia Research Institute, The Catholic University of Korea) ;
  • Kim, Soo-Hyun (Catholic Leukemia Research Institute, The Catholic University of Korea) ;
  • Song, Hye-Young (Catholic Leukemia Research Institute, The Catholic University of Korea) ;
  • Yoo, Hea-Lyun (Catholic Leukemia Research Institute, The Catholic University of Korea) ;
  • Lee, Mi-Young (Catholic Leukemia Research Institute, The Catholic University of Korea) ;
  • Kang, Ki-Hoon (Catholic Leukemia Research Institute, The Catholic University of Korea) ;
  • Hwang, Hee-Jeong (Catholic Leukemia Research Institute, The Catholic University of Korea) ;
  • Jang, Eun-Jung (Catholic Leukemia Research Institute, The Catholic University of Korea) ;
  • Kim, Dong-Wook (Catholic Leukemia Research Institute, The Catholic University of Korea)
  • Received : 2015.06.24
  • Accepted : 2015.08.04
  • Published : 2017.01.01
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Abstract

Background/Aims: The aim of this study was to identify the role of BCR-ABL1 transcript level as a predictor for post-transplant relapse and outcome in patients who underwent allogeneic stem cell transplantation (SCT) for chronic phase (CP) chronic myeloid leukemia (CML). Methods: Of 101 patients receiving allograft in CML CP, 85 had available quantitative reverse transcriptase polymerase chain reaction data at post-transplant 3 months. These patients were divided into two groups according to molecular response ($MR^{4{\cdot}5}$), defined as a BCR-ABL1 transcript level ${\leq}0.0032%$ on the international scale, at 3 months based on receiver operating characteristic curve analysis of relapse. Results: The 4-year overall survival and event-free survival (EFS) were 80.6% and 57.3%, respectively, and the cumulative incidence of relapse at 4 years was 29.6% after a median follow-up of 126.4 months. We performed multivariate analyses including potential variables to evaluate the early predictive role of $MR^{4{\cdot}5}$ at 3 months and found that $MR^{4{\cdot}5}$ at 3 months was associated with a higher EFS (p = 0.028) and showed a trend for a lower relapse rate (p = 0.089). Conclusions: our results imply that frequent molecular monitoring and immune suppressive therapy modulation are required for patients without reduction of BCR-ABL1 transcripts to this level after SCT.

Keywords

Acknowledgement

Supported by : Ministry of Health and Welfare, Korea Leukemia Bank

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