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See Latest ArticlesEarly prediction of success or failure using second generation tyrosine kinase inhibitors for chronic myeloid leukemia
Haematologica, 10/21/09
Milojkovic D et al. – Factors measurable before starting treatment can accurately predict response to 2G-TKI. Cytogenetic responses at 3, 6 and 12 months may influence the decision to continue 2G-TKI.
Methods- Cohort of 80 CML patients resistant to imatinib
- Treated with dasatinib or nilotinib while still in first chronic phase and devised scoring system to predict probability of achieving complete cytogenetic response (CCyR) to second generation tyrosine kinase inhibitors (2G-TKI)
- System based on 3 factors, namely cytogenetic response to imatinib, Sokal score and recurrent neutropenia on imatinib
- Validated score with independent sample of 28 Scottish patients
- Studied relationship between cytogenetic responses at 3, 6 and 12 months and subsequent outcome
- Classified the 80 patients into 3 categories, good risk (n=24), intermediate risk (n=27) and poor risk (n=29) with 2.5 year cumulative incidences of CCyR of 100%, 52.2% and 13.8% respectively
- Patients who were < 95% Ph-positive at 3 months, ≤ 35% Ph-positive at 6 months or in CCyR at 12 months all had significantly better outcomes compared with patients with lesser degrees of cytogenetic response
Dragana Milojkovic, 10/22/09
| The Hammersmith score incorporates a significant set of prognostic variables that are able to predict the outcome of patients on a 2G-TKI based on their previous response to imatinib. Factors measurable even before starting 2G-TKI treatment can accurately predict response to 2G-TKI and cytogenetic evaluation at 3, 6 and 12 months may influence the decision to continue this therapy. Importantly, the time from detection of imatinib resistance to the start of 2G-TKI therapy will influence the patient's outcome. The independently validated score allows physicians to predict the clinical results of their patients on a 2G-TKI and to be able to investigate other therapeutic modalities should the responses, which can be evaluated very early in the course 2G-TKI treatment not prove satisfactory. |
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