1. Halving Time of BCR-ABL1 in Chronic Myeloid Leukemia: Is It Better Than Day-90 Value—A Multicenter Study From South India
- Author
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Janarthinakani Murugesan, Manjunath Nandennavar, Mallikarjun Kalashetty, Roshan Koshy Jacob, Roopa Sirigeri, Krishna Prasad, Ramanan Ganapathy, K. Krishna Reddy, Parameswaran Anoop, Krishnakumar Rathnam, Arun Seshachalam, Channappa N Patil, Karthik S Udupa, Shashidhar V. Karpurmath, Baswant Malipatil, Neelesh Reddy, Priyadarshini Rajamani, Kalaiselvi Selvaraj, Satish kumar, and Madhav Danthala
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Fusion Proteins, bcr-abl ,India ,Context (language use) ,Disease cluster ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Leukemia, Myelogenous, Chronic, BCR-ABL Positive ,hemic and lymphatic diseases ,Internal medicine ,Humans ,Medicine ,Cutoff ,Receiver operating characteristic ,business.industry ,Medical record ,Area under the curve ,Myeloid leukemia ,Retrospective cohort study ,Hematology ,Middle Aged ,Survival Rate ,Oncology ,030220 oncology & carcinogenesis ,Female ,business ,030215 immunology - Abstract
The 90-day BCR-ABL1 (breakpoint cluster region-Abelson 1) level has been one of the accepted milestones for predicting the molecular response in patients with chronic myeloid leukemia (CML). The rate of decline in BCR-ABL1 has been considered a better predictor of the response but has not been uniformly accepted. A paucity of evidence is available to predict the accuracy of the rate of decline in the Indian context. Therefore, we tested the accuracy of the rate of decline of BCR-ABL1 in predicting the molecular response compared with the single 90-day values in a retrospective cohort study of selected cancer centers in south India.Patients with chronic-phase CML diagnosed from January 2013 to December 2018, the serial BCR-ABL1 levels were estimated at 0, 45, and 90 days, 6 months, and 1 year. Data on patient demographics, risk stratification assessed using the Sokal and EUTOS (European Treatment and Outcome Study) scores were extracted using a mobile-based data capture tool from the medical records of the enrolled patients. The halving time, determined by log reduction, was compared with the 90-day BCR-ABL1 values using the receiver operating characteristic curve for the major and complete molecular response at 6 months and 1 year as standards. Accuracy was determined from the area under the curve. The cutoff for the halving time was chosen to balance the sensitivity and specificity.The rate of decline had more predictive accuracy compared with the 90-day BCR-ABL1 values (area under the curve for rate of decline, 0.83; 90-day, 0.80). A halving time of 20 days identified 95% of the patients who had achieved major molecular response at 12 months compared with 80% using the single 90-day BCR-ABL1 response.The halving time of BCR-ABL1 appears promising as a predictor of the outcomes for patients with CML.
- Published
- 2020
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