Prediction of initial cytogenetic response for subsequent major and complete cytogenetic response to imatinib mesylate therapy in patients with Philadelphia chromosome‐positive chronic myelogenous leukemia

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Abstract
BACKGROUND Obtaining a major (Philadelphia chromosome [Ph] of < 35%) or a complete cytogenetic response (Ph of 0%) has been associated with excellent long‐term survival. Cytogenetic response may continue to improve with therapy. Because early allogeneic stem cell transplantation (SCT) may be associated with a better outcome, early parameters predicting for subsequent cytogenetic responses would optimize the treatment decision‐making. METHODS The current study was performed to analyze whether early cytogenetic responses may be predictive of later major or complete cytogenetic responses to imatinib mesylate therapy in patients with Ph‐positive chronic myelogenous leukemia (CML). RESULTS Two hundred sixty‐one patients with Ph‐positive, chronic‐phase CML after failure with interferon therapy who were treated with imatinib mesylate therapy were analyzed. A persistence of 100% Ph‐positive cells after ≥ 6 months of imatinib mesylate therapy was associated with a major cytogenetic response rate of 9–13% and a complete cytogenetic response rate of 0–4%. However, a minor cytogenetic response after 3–12 months of therapy still was associated with high rates of major (68–83%) or complete (35–54%) cytogenetic response rates. CONCLUSIONS Patients with Ph‐positive, chronic‐phase CML who have persistent 100% Ph‐positive disease after ≥ 6 months of imatinib mesylate therapy may be offered allogeneic SCT or considered for alternative investigational therapies. Cancer 2003;97:2225–8. © 2003 American Cancer Society. DOI 10.1002/cncr.11381

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