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Sustained MR4 and molecular monitoring in CML
Of these, 14 also lost CCyR at a median of six months (range: 1.3-55.4 months) from loss of MR3. The 1- and 5- year probabilities of loss of CCyR were 1.9% (95%CI: 0.5-6.5) and 13.1% (95%CI: 6.5-24.2) for those who achieved only sMR3 and 0 and 1.2% (95%CI: 0.4-3.5) for those who reached sMR4 (Figure 1C). Three of these patients experienced progression to accelerated phase, of
whom two died subsequently in blast phase and one achieved MR4 on a different TKI. Of the remaining 11 patients, at last follow up four were in complete hemato- logical response, two in CCyR, two in MR3, one in MR4, and two in MR4.5. The median follow up of the 22 patients who lost MR3 but not CCyR was 33.4 months (range: 5.4-135.4 months). At last follow up, ten had
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Figure 1. Probabilities of loss of responses after achieving sustained molecular response (MR)-3 (sMR3) and sMR4. (A) Probability of loss of MR3 and MR4 after the first year in MR4 (vertical line indicates time of sMR4, i.e. time at which MR4 was sustained for 12 months). (B) Probability of loss of MR3 for all 450 patients (vertical line indicates time of sMR3, i.e. time at which MR3 was sustained for 12 months) (blue curve); probability of loss of MR3 for patients who achieved sMR3 only (n=126) and those who achieved sMR4 (n=324) (green curves). (C) Probability of loss of complete cytogenetic response (CCyR) for patients who achieved sMR3 only (n=126) and those who achieved sMR4 (n=324). n: number; CI: Confidence Interval.
haematologica | 2019; 104(11)
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