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Complete cytogenetic and molecular responses to interferon-α-based therapy for chronic myelogenous leukemia are associated with excellent long-term prognosis
Article first published online: 3 FEB 2003
Copyright © 2003 American Cancer Society
Volume 97, Issue 4, pages 1033–1041, 15 February 2003
How to Cite
Kantarjian, H. M., O'Brien, S., Cortes, J. E., Shan, J., Giles, F. J., Rios, M. B., Faderl, S. H., Wierda, W. G., Ferrajoli, A., Verstovsek, S., Keating, M. J., Freireich, E. J. and Talpaz, M. (2003), Complete cytogenetic and molecular responses to interferon-α-based therapy for chronic myelogenous leukemia are associated with excellent long-term prognosis. Cancer, 97: 1033–1041. doi: 10.1002/cncr.11223
- Issue published online: 3 FEB 2003
- Article first published online: 3 FEB 2003
- Manuscript Accepted: 16 DEC 2002
- Manuscript Received: 20 NOV 2002
- chronic myelogenous leukemia (CML);
- interferon-α (IFN-α);
- complete durable cytogenetic response;
- molecular response
Little is known regarding long-term prognosis among patients with Philadelphia chromosome (Ph)-positive chronic myelogenous leukemia (CML) who achieve a complete cytogenetic response (0% Ph-positive cells) after treatment with interferon-α.
The authors analyzed 512 patients with Ph-positive, early chronic-phase CML who were treated with interferon-based therapies between 1981–1995 for the incidence and durability of complete cytogenetic response, and in relation to long-term prognosis.
One hundred forty patients (27%) achieved a complete cytogenetic response. Their 10-year survival rate was 78%. At the time of last follow-up, 44 patients (31%, 9% of the total) were alive, 21 in first and 23 in second durable complete cytogenetic response (median, 127 months; range, 88–191 months); 39 patients had not received any therapy for a median of 50 months (range, 11–139 months). Analysis by reverse transcriptase-polymerase chain reaction in 78 patients during complete cytogenetic response showed 46 who had achieved at least 1 complete molecular response. Five of these 78 patients had died by the time of last follow-up, but only 2 had died of disease-specific causes. Recurrence rates were significantly lower and cytogenetic response durations were significantly longer among patients who achieved at least one complete molecular response.
Achieving a complete cytogenetic or molecular response after therapy with interferon-α appears to be associated with excellent long-term prognosis. Approximately 10% of patients reportedly can achieve durable complete cytogenetic response, with or without continuation of interferon. This finding emphasizes the potential of long-term event-free survival in CML patients outside the context of allogeneic stem cell transplantation, which may be improved with new therapies such as imatinib mesylate. Cancer 2003;97:1033–41. © 2003 American Cancer Society.