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Rare Subtype May Have Prognostic Significance

Blood Cancer J; ePub 2017 Jul 14; Gong, et al

Though rare, the e1a2 transcript subtype appears to be a new high-risk factor for progression of chronic myeloid leukemia (CML), according to a study involving more than 2,300 individuals.

Participants had CML, carried a BCR-ABL1 subtype, and were receiving tyrosine kinase inhibitors. Investigators looked at the frequency of e1a2 transcript, risk of blastic transformation, treatment response, and outcomes. Among the results:

  • 98% had typical transcripts; most of the remainder had the e1a2 transcript.
  • Patients with the e1a2 transcript had a median time to complete cytogenetic remission (CCyR) of ~53 months, vs ~19 months for those with typical transcripts.
  • CCyR rates were 33% and 67%, respectively, at a median follow-up of 53 months.
  • The rates for achieving major molecular remission were 19% and 64%, respectively, at a median follow-up of ~60 months.
  • The differences remained significant when excluding patients with blast phase or additional chromosomal abnormalities (ACAs) initially, as well as those with unknown emerging time of ACAs.

Citation:

Gong Z, Medeiros L, Cortes J, et al. Clinical and prognostic significance of e1a2 BCR-ABL1 transcript subtype in chronic myeloid leukemia. [Published online ahead of print July 14, 2017]. Blood Cancer J. doi:10.1038/bcj.2017.62.