Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/9720
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Type: Journal article
Title: Frequency of major molecular responses to imatinib or interferon alfa plus cytarabine in newly diagnosed chronic myeloid leukemia
Author: Hughes, T.
Kaeda, J.
Branford, S.
Rudzki, Z.
Hochhaus, A.
Hensley, M.
Gathmann, I.
Bolton, A.
van Hoomissen, I.
Goldman, J.
Radich, J.
Citation: New England Journal of Medicine, 2003; 349(15):1423-1432
Publisher: Massachusetts Medical Soc
Issue Date: 2003
ISSN: 0028-4793
1533-4406
Statement of
Responsibility: 
Hughes, Tim P ; Kaeda, Jaspal ; Branford, Susan ; Rudzki, Zbigniew ; Hochhaus, Andreas ; Hensley, Martee L ; Gathmann, Insa ; Bolton, Ann E ; Van Hoomissen, Iris C ; Goldman, John M ; Radich, Jerald P
Abstract: BACKGROUND: In a randomized trial, 1106 patients with chronic myeloid leukemia (CML) in chronic phase were assigned to imatinib or interferon alfa plus cytarabine as initial therapy. We measured levels of BCR-ABL transcripts in the blood of all patients in this trial who had a complete cytogenetic remission. METHODS: Levels of BCR-ABL transcripts were measured by a quantitative real-time polymerase-chain-reaction assay. Results were expressed relative to the median level of BCR-ABL transcripts in the blood of 30 patients with untreated CML in chronic phase. RESULTS: In patients who had a complete cytogenetic remission, levels of BCR-ABL transcripts after 12 months of treatment had fallen by at least 3 log in 57 percent of those in the imatinib group and 24 percent of those in the group given interferon plus cytarabine (P=0.003). On the basis of the rates of complete cytogenetic remission of 68 percent in the imatinib group and 7 percent in the group given interferon plus cytarabine at 12 months, an estimated 39 percent of all patients treated with imatinib but only 2 percent of all those given interferon plus cytarabine had a reduction in BCR-ABL transcript levels of at least 3 log (P<0.001). For patients who had a complete cytogenetic remission and a reduction in transcript levels of at least 3 log at 12 months, the probability of remaining progression-free was 100 percent at 24 months, as compared with 95 percent for such patients with a reduction of less than 3 log and 85 percent for patients who were not in complete cytogenetic remission at 12 months (P<0.001). CONCLUSIONS: The proportion of patients with CML who had a reduction in BCR-ABL transcript levels of at least 3 log by 12 months of therapy was far greater with imatinib treatment than with treatment with interferon plus cytarabine. Patients in the imatinib group with this degree of molecular response had a negligible risk of disease progression during the subsequent 12 months.
Keywords: International Randomised Study of Interferon versus STI571 (IRIS) Study Group; Humans; Piperazines; Pyrimidines; Interferon-alpha; Fusion Proteins, bcr-abl; Cytarabine; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Tumor Markers, Biological; Disease-Free Survival; Remission Induction; Actuarial Analysis; Reverse Transcriptase Polymerase Chain Reaction; Transcription, Genetic; Adolescent; Adult; Aged; Middle Aged; Female; Male; Leukemia, Myelogenous, Chronic, BCR-ABL Positive
RMID: 0020031160
DOI: 10.1056/NEJMoa030513
Appears in Collections:Medicine publications

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