Risk stratification of chromosomal abnormalities in chronic myelogenous leukemia in the era of tyrosine kinase inhibitor therapy

Wei Wang, Jorge E. Cortes, Guilin Tang, Joseph D. Khoury, Sa Wang, Carlos E. Bueso-Ramos, Joseph A. Digiuseppe, Zi Chen, Hagop M. Kantarjian, L. Jeffrey Medeiros, Shimin Hu

Research output: Contribution to journalArticle

Abstract

Clonal cytogenetic evolution with additional chromosomal abnormalities (ACAs) in chronic myelogenous leukemia (CML) is generally associated with decreased response to tyrosine kinase inhibitor (TKI) therapy and adverse survival. Although ACAs are considered as a sign of disease progression and have been used as one of the criteria for accelerated phase, the differential prognostic impact of individual ACAs in CML is unknown, and a classification system to reflect such prognostic impact is lacking. In this study, we aimed to address these questions using a large cohort of CML patients treated in the era of TKIs. We focused on cases with single chromosomal changes at the time of ACA emergence and stratified the 6 most common ACAs into 2 groups: group 1 with a relatively good prognosis including trisomy 8, 2Y, and an extra copy of Philadelphia chromosome; and group 2 with a relatively poor prognosis including i(17)(q10), 27/del7q, and 3q26.2 rearrangements. Patients in group 1 showed much better treatment response and survival than patients in group 2. When compared with cases with no ACAs, ACAs in group 2 conferred a worse survival irrelevant to the emergence phase and time. In contrast, ACAs in group 1 had no adverse impact on survival when they emerged from chronic phase or at the time of CML diagnosis. The concurrent presence of 2 or more ACAs conferred an inferior survival and can be categorized into the poor prognostic group.

Original languageEnglish (US)
Pages (from-to)2742-2750
Number of pages9
JournalBlood
Volume127
Issue number22
DOIs
StatePublished - Jun 2 2016
Externally publishedYes

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Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Chromosomes
Chromosome Aberrations
Protein-Tyrosine Kinases
Survival
Therapeutics
Clonal Evolution
Philadelphia Chromosome
Cytogenetics
Disease Progression

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Risk stratification of chromosomal abnormalities in chronic myelogenous leukemia in the era of tyrosine kinase inhibitor therapy. / Wang, Wei; Cortes, Jorge E.; Tang, Guilin; Khoury, Joseph D.; Wang, Sa; Bueso-Ramos, Carlos E.; Digiuseppe, Joseph A.; Chen, Zi; Kantarjian, Hagop M.; Medeiros, L. Jeffrey; Hu, Shimin.

In: Blood, Vol. 127, No. 22, 02.06.2016, p. 2742-2750.

Research output: Contribution to journalArticle

Wang, W, Cortes, JE, Tang, G, Khoury, JD, Wang, S, Bueso-Ramos, CE, Digiuseppe, JA, Chen, Z, Kantarjian, HM, Medeiros, LJ & Hu, S 2016, 'Risk stratification of chromosomal abnormalities in chronic myelogenous leukemia in the era of tyrosine kinase inhibitor therapy', Blood, vol. 127, no. 22, pp. 2742-2750. https://doi.org/10.1182/blood-2016-01-690230
Wang, Wei ; Cortes, Jorge E. ; Tang, Guilin ; Khoury, Joseph D. ; Wang, Sa ; Bueso-Ramos, Carlos E. ; Digiuseppe, Joseph A. ; Chen, Zi ; Kantarjian, Hagop M. ; Medeiros, L. Jeffrey ; Hu, Shimin. / Risk stratification of chromosomal abnormalities in chronic myelogenous leukemia in the era of tyrosine kinase inhibitor therapy. In: Blood. 2016 ; Vol. 127, No. 22. pp. 2742-2750.
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