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Durability of molecular remission in chronic myeloid leukemia patients treated with imatinib vs allogeneic stem cell transplantation

Leukemia volume 19, pages 1262–1265 (2005)Cite this article

TO THE EDITOR

In CML patients treated with allogeneic stem cell transplantation, achievement of molecular remission (MR), defined as undetectable BCR–ABL transcripts by nested RT-PCR, is associated with a low risk of relapse.1 Imatinib induces high rates of complete cytogenetic response (CCR) in CML patients in chronic phase,2 giving rise to hopes that stable MR may be achievable with nontransplant therapy. However, the reported incidence of MR in patients on imatinib varies greatly across different studies, likely reflecting differences in the sensitivity of the PCR assay, patient selection and possibly imatinib dose. For example, in the randomized trial that compared imatinib with interferon-alpha (IFN-alpha)/cytarabine, less than 4% of newly diagnosed patients with CCR became RT-PCR-negative on at least one occasion.3 Similar, in a study of 120 patients treated with imatinib in late chronic phase the rate of MR was 0%.4 A recently published study in a comparable cohort of patients reported an MR rate of 11.5%.5 Since none of these studies addressed the durability of imatinib-induced MR or provided a side-by-side comparison with allografting, we directly compared two cohorts of patients treated with imatinib or allografting who were monitored at a single center with identical assays. For the purpose of this study, MR was defined as the first negative nested RT-PCR test at least 100 days post transplant (in the case of allografting) or as the first negative nested RT-PCR test after initiating imatinib therapy. The duration of MR was defined as the time from the first MR to loss of MR or last follow-up sample.

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Authors and Affiliations

  1. Department of Hematology and Oncology, University of Leipzig, Germany

    T Lange, T Bumm, S Otto, H-K Al-Ali, L Grommisch, S Musiol, C Franke, R Krahl & D Niederwieser

  2. Department of Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Germany

    M Mueller

  3. Center for Hematologic Malignancies, Oregon Health & Science University, Portland, OR, USA

    M W N Deininger

Authors
  1. T Lange
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  2. T Bumm
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  3. M Mueller
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  4. S Otto
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  5. H-K Al-Ali
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  7. S Musiol
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  11. M W N Deininger
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Correspondence to M W N Deininger.

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Lange, T., Bumm, T., Mueller, M. et al. Durability of molecular remission in chronic myeloid leukemia patients treated with imatinib vs allogeneic stem cell transplantation. Leukemia 19, 1262–1265 (2005). https://doi.org/10.1038/sj.leu.2403752

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