ABSTRACT
<p><b>INTRODUCTION</b>The prognosis of patients with chronic myeloid leukaemia (CML) has improved since the introduction of imatinib. However, patients who do not achieve complete cytogenetic response (CCyR) and major molecular response (MMR) have poorer prognosis. Recent clinical trials have demonstrated that early and deeper cytogenetic and molecular responses predict a better long-term outcome. This study aimed to analyse the relationship between early molecular response and clinical outcome in a real-life setting.</p><p><b>METHODS</b>This retrospective study included all patients with CML, in chronic or accelerated phase, who were treated with imatinib at University of Malaya Medical Centre, Malaysia.</p><p><b>RESULTS</b>A total of 70 patients were analysed. The median follow-up duration was 74 months, and the cumulative percentages of patients with CCyR and MMR were 80.0% and 65.7%, respectively. Overall survival (OS) and event-free survival (EFS) at ten years were 94.3% and 92.9%, respectively. Patients who achieved CCyR and MMR had significantly better OS and EFS than those who did not. At six months, patients who had a BCR-ABL level ≤ 10% had significantly better OS and EFS than those who had a BCR-ABL level > 10%. The target milestone of CCyR at 12 months and MMR at 18 months showed no survival advantage in our patients.</p><p><b>CONCLUSION</b>Our data showed that imatinib is still useful as first-line therapy. However, vigilant monitoring of patients who have a BCR-ABL level > 10% at six months of treatment should be implemented so that prompt action can be taken to provide the best outcome for these patients.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Academic Medical Centers , Antineoplastic Agents , Therapeutic Uses , Cytogenetics , Disease-Free Survival , Follow-Up Studies , Fusion Proteins, bcr-abl , Metabolism , Imatinib Mesylate , Therapeutic Uses , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Diagnosis , Drug Therapy , Genetics , Malaysia , Predictive Value of Tests , Prognosis , Retrospective Studies , Treatment Outcome , UniversitiesABSTRACT
OBJECTIVE:To observe the efficacy and safety of Zhenqi fuzheng granule combined with dasatinib in the treat-ment of BCR/ABL positive leukemia. METHODS:40 patients with BCR-ABL positive chronic myeloid leukemia or PH-positive acute lymphoblastic leukemia were randomly divided into control group(20 cases)and observation group(20 cases). Control group received Dasatinib tablet,CML patients in chronic period received 100 mg,once a day,orally,morning or evening;CML patients in acceleration period and blastic period received 140 mg,once a day,orally,morning or evening,swallow whole,no cut or crushed. Observation group additionally received 15 g of Zhenqi fuzheng granule,twice a day. The treatment course for both groups was 24 months. Hematologic response,cytogenetic response and molecular biological response in 2 groups were observed, fatality rate,mean follow-up time and the incidence of adverse reactions were followed-up. RESULTS:CCR in observation group was significantly higher than control group,mean follow-up time was longer than control group,CCR median time was significant-ly shorter than control group,the incidence of adverse reactions and fatality rate were significantly lower than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Zhenqi fuzheng granule combined with dasatinib is superior to dasat-inib alone in proving hematologic response and safety in the treatment of BCR-ABL positive leukemia,and similar in cytogenetic response and molecular biological response.