Response to treatment in CML patients with e1a2 BCR-ABL fusion transcripts
| Pt no. . | Age/ sex . | CML f/up, mo . | Frontline . | 1st salvage . | 2nd salvage . | 3rd salvage . | 4th salvage . | Time to progress, mo . | CML status . | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Rx . | CML stage . | Best respon . | EFS . | Rx . | CML stage . | Best respon . | EFS . | Rx . | CML stage . | Best respon . | EFS . | Rx . | CML stage . | Best respon . | EFS . | Rx . | CML stage . | Best respon . | EFS . | |||||
| 1 | 28/F | 108 | IFN | CP | NR | 0 | IFN + AraC | CP | CHR | 8 | Allo | CP | CCyR | 6 | IM | CP | CHR | 40 | Allo | CP | NR | 0 | 89 | Died in MyBP |
| 2 | 64/F | 109 | IFN | CP | NR | 0 | HHT + AraC | CP | CHR | 9 | IM | CP | PCyR | 6 | Nilot | AP (CE) | PCyR | 5 | Dasat | MyBP | NR | 0 | 92 | Died in MyBP |
| 3 | 55/F | 85 | IFN | CP | NR | 0 | IFN + AraC | CP | NR | 0 | IM | CP | CHR | 65+ | — | — | — | — | — | — | — | — | — | CHR |
| 4 | 79/F | 73 | IM | CP | CHR | 73+ | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | CHR |
| 5 | 35/M | 57 | IM | CP | CCyR | 9 | Dasat | AP (CE) | CCyR | 3 | I + A | AP | NR | 0 | 2-CdA | AP | NR | 0 | AraC + Mitox | AP | NR | 0 | 48 | Died in AP |
| 6 | 61/F | 13 | IM | CP | CHR | 4 | None | MyBP | — | — | — | — | — | — | — | — | — | — | — | — | — | — | 10 | Died in MyBP |
| 7 | 38/F | 39 | IM | CP | NR | — | HCVAD + IM | LyBP | NR | 0 | MTX + AraC | LyBP | NR | 0 | HCVAD + Dasat | LyBP | CCyR | 4 | Allo | CP (CCyR) | CMR | 9+ | 4 | CMR |
| 8 | 60/M | 20 | IM | CP | PCyR | 18+ | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | CHR, PCyR |
| 9 | 86/F | 3 | Nilot | CP | CCyR | 3+ | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | CCyR |
| 10 | 46/M | 55 | IM | AP (CE) | CHR, no CE | 12 | Dasat | CP (CHR) | CHR | 27 | Bosu | CP (CHR) | CHR | 12+ | — | — | — | — | — | — | — | — | — | CHR, CE gone |
| 11 | 59/M | 8 | I + A | MyBP | NR | 0 | HD AraC | MyBP | NR | 0 | IM | MyBP | CHR | 0.75 | — | — | — | — | — | — | — | — | — | Died in MyBP w/ Breast Ca mets |
| 12 | 66/M | 11 | HCVAD + IM | LyBP | NR | 0 | IM | LyBP | CHR | 0.25 | Clofarabine | LyBP | CCyR | 0.5 | IM | LyBP | NR | 0 | — | — | — | — | — | Died in LyBP |
| 13 | 47/F | 40 | HCVAD + IM | LyBP | CCyR | 12 | Dasat | LyBP | CCyR | 1 | HCVAD | LyBP | NR | 0 | Auto | LyBP | CCyR | 3 | — | — | — | — | — | Died in LyBP |
| 14 | 62/M | 14 | IM | LyBP | NR | 0 | HCVAD + Dasat | LyBP | MMR | 2 | Allo | CP, MMR | CMR | 2 | KW-2449 | LyBP | NR | 0 | — | — | — | — | — | Died in LyBP |
| Pt no. . | Age/ sex . | CML f/up, mo . | Frontline . | 1st salvage . | 2nd salvage . | 3rd salvage . | 4th salvage . | Time to progress, mo . | CML status . | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Rx . | CML stage . | Best respon . | EFS . | Rx . | CML stage . | Best respon . | EFS . | Rx . | CML stage . | Best respon . | EFS . | Rx . | CML stage . | Best respon . | EFS . | Rx . | CML stage . | Best respon . | EFS . | |||||
| 1 | 28/F | 108 | IFN | CP | NR | 0 | IFN + AraC | CP | CHR | 8 | Allo | CP | CCyR | 6 | IM | CP | CHR | 40 | Allo | CP | NR | 0 | 89 | Died in MyBP |
| 2 | 64/F | 109 | IFN | CP | NR | 0 | HHT + AraC | CP | CHR | 9 | IM | CP | PCyR | 6 | Nilot | AP (CE) | PCyR | 5 | Dasat | MyBP | NR | 0 | 92 | Died in MyBP |
| 3 | 55/F | 85 | IFN | CP | NR | 0 | IFN + AraC | CP | NR | 0 | IM | CP | CHR | 65+ | — | — | — | — | — | — | — | — | — | CHR |
| 4 | 79/F | 73 | IM | CP | CHR | 73+ | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | CHR |
| 5 | 35/M | 57 | IM | CP | CCyR | 9 | Dasat | AP (CE) | CCyR | 3 | I + A | AP | NR | 0 | 2-CdA | AP | NR | 0 | AraC + Mitox | AP | NR | 0 | 48 | Died in AP |
| 6 | 61/F | 13 | IM | CP | CHR | 4 | None | MyBP | — | — | — | — | — | — | — | — | — | — | — | — | — | — | 10 | Died in MyBP |
| 7 | 38/F | 39 | IM | CP | NR | — | HCVAD + IM | LyBP | NR | 0 | MTX + AraC | LyBP | NR | 0 | HCVAD + Dasat | LyBP | CCyR | 4 | Allo | CP (CCyR) | CMR | 9+ | 4 | CMR |
| 8 | 60/M | 20 | IM | CP | PCyR | 18+ | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | CHR, PCyR |
| 9 | 86/F | 3 | Nilot | CP | CCyR | 3+ | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | — | CCyR |
| 10 | 46/M | 55 | IM | AP (CE) | CHR, no CE | 12 | Dasat | CP (CHR) | CHR | 27 | Bosu | CP (CHR) | CHR | 12+ | — | — | — | — | — | — | — | — | — | CHR, CE gone |
| 11 | 59/M | 8 | I + A | MyBP | NR | 0 | HD AraC | MyBP | NR | 0 | IM | MyBP | CHR | 0.75 | — | — | — | — | — | — | — | — | — | Died in MyBP w/ Breast Ca mets |
| 12 | 66/M | 11 | HCVAD + IM | LyBP | NR | 0 | IM | LyBP | CHR | 0.25 | Clofarabine | LyBP | CCyR | 0.5 | IM | LyBP | NR | 0 | — | — | — | — | — | Died in LyBP |
| 13 | 47/F | 40 | HCVAD + IM | LyBP | CCyR | 12 | Dasat | LyBP | CCyR | 1 | HCVAD | LyBP | NR | 0 | Auto | LyBP | CCyR | 3 | — | — | — | — | — | Died in LyBP |
| 14 | 62/M | 14 | IM | LyBP | NR | 0 | HCVAD + Dasat | LyBP | MMR | 2 | Allo | CP, MMR | CMR | 2 | KW-2449 | LyBP | NR | 0 | — | — | — | — | — | Died in LyBP |
CP indicates chronic phase; AP, accelerated phase; CE, clonal evolution; BP, blast phase; MyBP, myeloid blast phase; LyBP, lymphoid blast phase; no., number; f/up, follow up; mo, months; Rx, treatment; respon, response; EFS, event-free survival (in months); CHR, complete hematologic response; CCyR, complete cytogenetic response; PCyR, partial cytogenetic response; MCyR, major cytogenetic response; CyR, cytogenetic response; MMR, major molecular response; CMR, complete molecular response; NR, no response; SCT, stem cell transplantation; Allo, allogeneic SCT; Auto, autologous SCT; IFN, interferon; TKI, tyrosine kinase inhibitor; IM, imatinib; Nilot, nilotinib; Dasat, dasatinib; Bosu, bosutinib; I+A, idarubicin + Ara-C (cytarabine); HD AraC, high-dose Ara-C; 2-CdA, 2 chlorodexoyadenosine; Mitox, mitoxantrone; KW-2449, investigational new drug; HCVAD, hyperfractionated cyclophosphamide, vincristine, adriamycin, dexamethasone; MTX, methotrexate; mets, metastasis; and —, none.
Patient 1 received 50 salvage with nilotinib in AP and achieved CHR for 12 months, then received sixth salvage with dasatinib in MyBP and had no response.