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<title xml:lang="en">Long-term prognostic significance of early molecular response to imatinib in newly diagnosed chronic myeloid leukemia: an analysis from the International Randomized Study of Interferon and STI571 (IRIS)</title>
<author>
<name sortKey="Hughes, Timothy P" sort="Hughes, Timothy P" uniqKey="Hughes T" first="Timothy P." last="Hughes">Timothy P. Hughes</name>
<affiliation>
<nlm:aff id="aff1">Department of Haematology, SA Pathology, Royal Adelaide Hospital, Adelaide, Australia;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Hochhaus, Andreas" sort="Hochhaus, Andreas" uniqKey="Hochhaus A" first="Andreas" last="Hochhaus">Andreas Hochhaus</name>
<affiliation>
<nlm:aff id="aff2">Abt Hämatologie und internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Branford, Susan" sort="Branford, Susan" uniqKey="Branford S" first="Susan" last="Branford">Susan Branford</name>
<affiliation>
<nlm:aff id="aff3">Molecular Pathology, SA Pathology, Adelaide, Australia and School of Medicine, University of Adelaide, Adelaide, Australia;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Muller, Martin C" sort="Muller, Martin C" uniqKey="Muller M" first="Martin C." last="Müller">Martin C. Müller</name>
<affiliation>
<nlm:aff id="aff4">III Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kaeda, Jaspal S" sort="Kaeda, Jaspal S" uniqKey="Kaeda J" first="Jaspal S." last="Kaeda">Jaspal S. Kaeda</name>
<affiliation>
<nlm:aff id="aff5">Department of Hematology, Central Hospital of Coimbra, Coimbra, Portugal;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Foroni, Letizia" sort="Foroni, Letizia" uniqKey="Foroni L" first="Letizia" last="Foroni">Letizia Foroni</name>
<affiliation>
<nlm:aff id="aff6">Haematology Department, Hammersmith Hospital, London, United Kingdom;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Druker, Brian J" sort="Druker, Brian J" uniqKey="Druker B" first="Brian J." last="Druker">Brian J. Druker</name>
<affiliation>
<nlm:aff id="aff7">Knight Cancer Institute, Oregon Health & Science University, Portland, OR;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Guilhot, Francois" sort="Guilhot, Francois" uniqKey="Guilhot F" first="François" last="Guilhot">François Guilhot</name>
<affiliation>
<nlm:aff id="aff8">Centre d'Investigation Clinique CIC P 802, Inserm, Centre Hospitalier Universitaire de Poitiers, Poitiers, France;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Larson, Richard A" sort="Larson, Richard A" uniqKey="Larson R" first="Richard A." last="Larson">Richard A. Larson</name>
<affiliation>
<nlm:aff id="aff9">University of Chicago, Chicago, IL;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="O Brien, Stephen G" sort="O Brien, Stephen G" uniqKey="O Brien S" first="Stephen G." last="O'Brien">Stephen G. O'Brien</name>
<affiliation>
<nlm:aff id="aff10">Newcastle University Medical School, Newcastle, United Kingdom;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Rudoltz, Marc S" sort="Rudoltz, Marc S" uniqKey="Rudoltz M" first="Marc S." last="Rudoltz">Marc S. Rudoltz</name>
<affiliation>
<nlm:aff id="aff11">Novartis Pharmaceuticals Corporation, East Hanover, NJ;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mone, Manisha" sort="Mone, Manisha" uniqKey="Mone M" first="Manisha" last="Mone">Manisha Mone</name>
<affiliation>
<nlm:aff id="aff11">Novartis Pharmaceuticals Corporation, East Hanover, NJ;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Wehrle, Elisabeth" sort="Wehrle, Elisabeth" uniqKey="Wehrle E" first="Elisabeth" last="Wehrle">Elisabeth Wehrle</name>
<affiliation>
<nlm:aff id="aff12">Novartis Pharma AG, Basel, Switzerland;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Modur, Vijay" sort="Modur, Vijay" uniqKey="Modur V" first="Vijay" last="Modur">Vijay Modur</name>
<affiliation>
<nlm:aff wicri:cut="; and" id="aff13">Novartis Institute of Biomedical Research, Cambridge, MA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Goldman, John M" sort="Goldman, John M" uniqKey="Goldman J" first="John M." last="Goldman">John M. Goldman</name>
<affiliation>
<nlm:aff id="aff6">Haematology Department, Hammersmith Hospital, London, United Kingdom;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Radich, Jerald P" sort="Radich, Jerald P" uniqKey="Radich J" first="Jerald P." last="Radich">Jerald P. Radich</name>
<affiliation>
<nlm:aff id="aff14">Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA</nlm:aff>
</affiliation>
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<idno type="doi">10.1182/blood-2010-03-273979</idno>
<date when="2010">2010</date>
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<title xml:lang="en" level="a" type="main">Long-term prognostic significance of early molecular response to imatinib in newly diagnosed chronic myeloid leukemia: an analysis from the International Randomized Study of Interferon and STI571 (IRIS)</title>
<author>
<name sortKey="Hughes, Timothy P" sort="Hughes, Timothy P" uniqKey="Hughes T" first="Timothy P." last="Hughes">Timothy P. Hughes</name>
<affiliation>
<nlm:aff id="aff1">Department of Haematology, SA Pathology, Royal Adelaide Hospital, Adelaide, Australia;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Hochhaus, Andreas" sort="Hochhaus, Andreas" uniqKey="Hochhaus A" first="Andreas" last="Hochhaus">Andreas Hochhaus</name>
<affiliation>
<nlm:aff id="aff2">Abt Hämatologie und internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Branford, Susan" sort="Branford, Susan" uniqKey="Branford S" first="Susan" last="Branford">Susan Branford</name>
<affiliation>
<nlm:aff id="aff3">Molecular Pathology, SA Pathology, Adelaide, Australia and School of Medicine, University of Adelaide, Adelaide, Australia;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Muller, Martin C" sort="Muller, Martin C" uniqKey="Muller M" first="Martin C." last="Müller">Martin C. Müller</name>
<affiliation>
<nlm:aff id="aff4">III Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kaeda, Jaspal S" sort="Kaeda, Jaspal S" uniqKey="Kaeda J" first="Jaspal S." last="Kaeda">Jaspal S. Kaeda</name>
<affiliation>
<nlm:aff id="aff5">Department of Hematology, Central Hospital of Coimbra, Coimbra, Portugal;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Foroni, Letizia" sort="Foroni, Letizia" uniqKey="Foroni L" first="Letizia" last="Foroni">Letizia Foroni</name>
<affiliation>
<nlm:aff id="aff6">Haematology Department, Hammersmith Hospital, London, United Kingdom;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Druker, Brian J" sort="Druker, Brian J" uniqKey="Druker B" first="Brian J." last="Druker">Brian J. Druker</name>
<affiliation>
<nlm:aff id="aff7">Knight Cancer Institute, Oregon Health & Science University, Portland, OR;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Guilhot, Francois" sort="Guilhot, Francois" uniqKey="Guilhot F" first="François" last="Guilhot">François Guilhot</name>
<affiliation>
<nlm:aff id="aff8">Centre d'Investigation Clinique CIC P 802, Inserm, Centre Hospitalier Universitaire de Poitiers, Poitiers, France;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Larson, Richard A" sort="Larson, Richard A" uniqKey="Larson R" first="Richard A." last="Larson">Richard A. Larson</name>
<affiliation>
<nlm:aff id="aff9">University of Chicago, Chicago, IL;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="O Brien, Stephen G" sort="O Brien, Stephen G" uniqKey="O Brien S" first="Stephen G." last="O'Brien">Stephen G. O'Brien</name>
<affiliation>
<nlm:aff id="aff10">Newcastle University Medical School, Newcastle, United Kingdom;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Rudoltz, Marc S" sort="Rudoltz, Marc S" uniqKey="Rudoltz M" first="Marc S." last="Rudoltz">Marc S. Rudoltz</name>
<affiliation>
<nlm:aff id="aff11">Novartis Pharmaceuticals Corporation, East Hanover, NJ;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mone, Manisha" sort="Mone, Manisha" uniqKey="Mone M" first="Manisha" last="Mone">Manisha Mone</name>
<affiliation>
<nlm:aff id="aff11">Novartis Pharmaceuticals Corporation, East Hanover, NJ;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Wehrle, Elisabeth" sort="Wehrle, Elisabeth" uniqKey="Wehrle E" first="Elisabeth" last="Wehrle">Elisabeth Wehrle</name>
<affiliation>
<nlm:aff id="aff12">Novartis Pharma AG, Basel, Switzerland;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Modur, Vijay" sort="Modur, Vijay" uniqKey="Modur V" first="Vijay" last="Modur">Vijay Modur</name>
<affiliation>
<nlm:aff wicri:cut="; and" id="aff13">Novartis Institute of Biomedical Research, Cambridge, MA</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Goldman, John M" sort="Goldman, John M" uniqKey="Goldman J" first="John M." last="Goldman">John M. Goldman</name>
<affiliation>
<nlm:aff id="aff6">Haematology Department, Hammersmith Hospital, London, United Kingdom;</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Radich, Jerald P" sort="Radich, Jerald P" uniqKey="Radich J" first="Jerald P." last="Radich">Jerald P. Radich</name>
<affiliation>
<nlm:aff id="aff14">Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Blood</title>
<idno type="ISSN">0006-4971</idno>
<idno type="eISSN">1528-0020</idno>
<imprint>
<date when="2010">2010</date>
</imprint>
</series>
</biblStruct>
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<textClass></textClass>
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<front>
<div type="abstract" xml:lang="en">
<p>This study examines the prognostic significance of early molecular response using an expanded dataset in chronic myeloid leukemia patients enrolled in the International Randomized Study of Interferon and STI571 (IRIS). Serial molecular studies demonstrate decreases in
<italic>BCR-ABL</italic>
transcripts over time. Analyses of event-free survival (EFS) and time to progression to accelerated phase/blast crisis (AP/BC) at 7 years were based on molecular responses using the international scale (IS) at 6-, 12-, and 18-month landmarks. Patients with
<italic>BCR-ABL</italic>
transcripts > 10% at 6 months and > 1% at 12 months had inferior EFS and higher rate of progression to AP/BC compared with all other molecular response groups. Conversely, patients who achieved major molecular response [MMR:
<italic>BCR-ABL</italic>
(IS) ≤ 0.1%] by 18 months enjoyed remarkably durable responses, with no progression to AP/BC and 95% EFS at 7 years. The probability of loss of complete cytogenetic response by 7 years was only 3% for patients in MMR at 18 months versus 26% for patients with complete cytogenetic response but not MMR (
<italic>P</italic>
< .001). This study shows a strong association between the degree to which
<italic>BCR-ABL</italic>
transcript numbers are reduced by therapy and long-term clinical outcome, supporting the use of time-dependent molecular measures to determine optimal response to therapy. This study is registered at
<ext-link ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">www.clinicaltrials.gov</ext-link>
as NCT00006343.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Blood</journal-id>
<journal-id journal-id-type="hwp">bloodjournal</journal-id>
<journal-id journal-id-type="pmc">blood</journal-id>
<journal-id journal-id-type="publisher-id">Blood</journal-id>
<journal-title-group>
<journal-title>Blood</journal-title>
</journal-title-group>
<issn pub-type="ppub">0006-4971</issn>
<issn pub-type="epub">1528-0020</issn>
<publisher>
<publisher-name>American Society of Hematology</publisher-name>
<publisher-loc>Washington, DC</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">20679528</article-id>
<article-id pub-id-type="pmc">3266053</article-id>
<article-id pub-id-type="publisher-id">2010/273979</article-id>
<article-id pub-id-type="doi">10.1182/blood-2010-03-273979</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Clinical Trials and Observations</subject>
</subj-group>
<series-title>Clinical Trials and Observations</series-title>
</article-categories>
<title-group>
<article-title>Long-term prognostic significance of early molecular response to imatinib in newly diagnosed chronic myeloid leukemia: an analysis from the International Randomized Study of Interferon and STI571 (IRIS)</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Hughes</surname>
<given-names>Timothy P.</given-names>
</name>
<xref ref-type="author-notes" rid="FN1">*</xref>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hochhaus</surname>
<given-names>Andreas</given-names>
</name>
<xref ref-type="author-notes" rid="FN1">*</xref>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Branford</surname>
<given-names>Susan</given-names>
</name>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Müller</surname>
<given-names>Martin C.</given-names>
</name>
<xref ref-type="aff" rid="aff4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kaeda</surname>
<given-names>Jaspal S.</given-names>
</name>
<xref ref-type="aff" rid="aff5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Foroni</surname>
<given-names>Letizia</given-names>
</name>
<xref ref-type="aff" rid="aff6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Druker</surname>
<given-names>Brian J.</given-names>
</name>
<xref ref-type="aff" rid="aff7">7</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Guilhot</surname>
<given-names>François</given-names>
</name>
<xref ref-type="aff" rid="aff8">8</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Larson</surname>
<given-names>Richard A.</given-names>
</name>
<xref ref-type="aff" rid="aff9">9</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>O'Brien</surname>
<given-names>Stephen G.</given-names>
</name>
<xref ref-type="aff" rid="aff10">10</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Rudoltz</surname>
<given-names>Marc S.</given-names>
</name>
<xref ref-type="aff" rid="aff11">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mone</surname>
<given-names>Manisha</given-names>
</name>
<xref ref-type="aff" rid="aff11">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wehrle</surname>
<given-names>Elisabeth</given-names>
</name>
<xref ref-type="aff" rid="aff12">12</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Modur</surname>
<given-names>Vijay</given-names>
</name>
<xref ref-type="aff" rid="aff13">13</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Goldman</surname>
<given-names>John M.</given-names>
</name>
<xref ref-type="aff" rid="aff6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Radich</surname>
<given-names>Jerald P.</given-names>
</name>
<xref ref-type="aff" rid="aff14">14</xref>
<on-behalf-of>on behalf of the IRIS investigators</on-behalf-of>
</contrib>
<aff id="aff1">
<label>1</label>
Department of Haematology, SA Pathology, Royal Adelaide Hospital, Adelaide, Australia;</aff>
<aff id="aff2">
<label>2</label>
Abt Hämatologie und internistische Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany;</aff>
<aff id="aff3">
<label>3</label>
Molecular Pathology, SA Pathology, Adelaide, Australia and School of Medicine, University of Adelaide, Adelaide, Australia;</aff>
<aff id="aff4">
<label>4</label>
III Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany;</aff>
<aff id="aff5">
<label>5</label>
Department of Hematology, Central Hospital of Coimbra, Coimbra, Portugal;</aff>
<aff id="aff6">
<label>6</label>
Haematology Department, Hammersmith Hospital, London, United Kingdom;</aff>
<aff id="aff7">
<label>7</label>
Knight Cancer Institute, Oregon Health & Science University, Portland, OR;</aff>
<aff id="aff8">
<label>8</label>
Centre d'Investigation Clinique CIC P 802, Inserm, Centre Hospitalier Universitaire de Poitiers, Poitiers, France;</aff>
<aff id="aff9">
<label>9</label>
University of Chicago, Chicago, IL;</aff>
<aff id="aff10">
<label>10</label>
Newcastle University Medical School, Newcastle, United Kingdom;</aff>
<aff id="aff11">
<label>11</label>
Novartis Pharmaceuticals Corporation, East Hanover, NJ;</aff>
<aff id="aff12">
<label>12</label>
Novartis Pharma AG, Basel, Switzerland;</aff>
<aff id="aff13">
<label>13</label>
Novartis Institute of Biomedical Research, Cambridge, MA; and</aff>
<aff id="aff14">
<label>14</label>
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA</aff>
</contrib-group>
<author-notes>
<fn fn-type="equal" id="FN1">
<label>*</label>
<p>T.H. and A.H. contributed equally to this work.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<day>11</day>
<month>11</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="epreprint">
<day>2</day>
<month>8</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>11</day>
<month>11</month>
<year>2011</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and 0 days and was based on the . </pmc-comment>
<volume>116</volume>
<issue>19</issue>
<fpage>3758</fpage>
<lpage>3765</lpage>
<history>
<date date-type="received">
<day>19</day>
<month>3</month>
<year>2010</year>
</date>
<date date-type="accepted">
<day>19</day>
<month>7</month>
<year>2010</year>
</date>
</history>
<permissions>
<copyright-statement>© 2010 by The American Society of Hematology</copyright-statement>
<copyright-year>2010</copyright-year>
</permissions>
<self-uri xlink:title="pdf" xlink:type="simple" xlink:href="zh804510003758.pdf"></self-uri>
<abstract>
<p>This study examines the prognostic significance of early molecular response using an expanded dataset in chronic myeloid leukemia patients enrolled in the International Randomized Study of Interferon and STI571 (IRIS). Serial molecular studies demonstrate decreases in
<italic>BCR-ABL</italic>
transcripts over time. Analyses of event-free survival (EFS) and time to progression to accelerated phase/blast crisis (AP/BC) at 7 years were based on molecular responses using the international scale (IS) at 6-, 12-, and 18-month landmarks. Patients with
<italic>BCR-ABL</italic>
transcripts > 10% at 6 months and > 1% at 12 months had inferior EFS and higher rate of progression to AP/BC compared with all other molecular response groups. Conversely, patients who achieved major molecular response [MMR:
<italic>BCR-ABL</italic>
(IS) ≤ 0.1%] by 18 months enjoyed remarkably durable responses, with no progression to AP/BC and 95% EFS at 7 years. The probability of loss of complete cytogenetic response by 7 years was only 3% for patients in MMR at 18 months versus 26% for patients with complete cytogenetic response but not MMR (
<italic>P</italic>
< .001). This study shows a strong association between the degree to which
<italic>BCR-ABL</italic>
transcript numbers are reduced by therapy and long-term clinical outcome, supporting the use of time-dependent molecular measures to determine optimal response to therapy. This study is registered at
<ext-link ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">www.clinicaltrials.gov</ext-link>
as NCT00006343.</p>
</abstract>
</article-meta>
</front>
</pmc>
</record>

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