The BCR-ABLT315I mutation compromises survival in chronic phase chronic myelogenous leukemia patients resistant to tyrosine kinase inhibitors, in a matched pair analysis

Franck E. Nicolini, Amr R. Ibrahim, Simona Soverini, Giovanni Martinelli, Martin C. Müller, Andreas Hochhaus, Inge H. Dufva, Dong Wook Kim, Jorge Cortes, Michael J. Mauro, Charles Chuah, Hélène Labussière, Stéphane Morisset, Catherine Roche-Lestienne, Eric Lippert, Sandrine Hayette, Senaka Peter, Wei Zhou, Véronique Maguer-Satta, Mauricette MichalletJohn Goldman, Jane F. Apperley, François Xavier Mahon, David Marin, Gabriel Etienne

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The BCR-ABL T315I mutation confers resistance to currently licensed tyrosine kinase inhibitors in chronic myelogenous leukemia. However, the impact of this mutation on survival in early stages of disease, in chronic phase, has never been detailed. Using matched pair analysis, a cohort of 64 patients with chronic phase chronic myelogenous leukemia harboring a T315I mutation and resistant to imatinib mesylate was compared to a similar cohort of 53 chronic phase patients resistant to imatinib, but with no detectable T315I mutation, in the pre-ponatinib era. These patients were matched according to age at diagnosis, interval between disease diagnosis and start of imatinib treatment, and duration of imatinib therapy. Kaplan-Meier survival analyses demonstrated the significant negative impact of the presence of the T315I mutation on overall survival (since imatinib-resistance: 48.4 months for T315I+ patients versus not reached for T315I- ones; P=0.006) and failure-free survival (since imatinib-resistance: 34.7 months for T315I+ patients versus not reached for T315I- patients; P=0.003). In addition, Cox proportional hazard models adjusted on overall survival demonstrated the negative influence of the T315I mutation (P=0.02, HR=2.54). These results confirm early assumptions concerning the poor prognosis of chronic phase chronic myelogenous leukemia patients with the T315I mutation who are not eligible for allogeneic transplantation, and demonstrate the need for more therapeutic options.

Original languageEnglish (US)
Pages (from-to)1510-1516
Number of pages7
Issue number10
Publication statusPublished - Oct 1 2013
Externally publishedYes


ASJC Scopus subject areas

  • Hematology

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