Monitoring Treatment-Free Remission by Droplet Digital PCR in CML Patients with Deep Molecular Response to Tyrosine Kinase Inhibitor: An Analysis Based on Real-World Data.

中止 医学 内科学 实时聚合酶链反应 髓系白血病 伊马替尼 酪氨酸激酶 酪氨酸激酶抑制剂 断点群集区域 胃肠病学 数字聚合酶链反应 肿瘤科 阿布勒 免疫学 聚合酶链反应 生物 受体 癌症 基因 生物化学
作者
Guiyang Zhu,Yuchao Yang,Hongwei Wang,Juan Xie,Jinjun Hu,Wenzheng Guo,Lingli Zhang,Zhuang Liu,Xiuhua Chen,Jianmei Chang,Jing Xu,Yanhong Tan
出处
期刊:Annals of Clinical and Laboratory Science [Association of Clinical Scientists]
卷期号:50 (5): 591-599 被引量:4
标识
摘要

Treatment-free remission (TFR) is emerging as a new therapy goal for chronic myeloid leukemia (CML) patients in the tyrosine kinase inhibitors (TKI) era. Data indicates the unfavorable success rate of TFR. This study aimed to compare and evaluate the clinical value of dd-PCR in predicting relapse in CML patients entering TFR. Using dd-PCR and RT-qPCR technology, dynamic BCR/ABL transcripts were detected in 13 CML patients who discontinued TKI treatment after sustaining undetectable BCR-ABL levels for a median time of 25 months. The results showed that in 13 patients, only 2 cases (22.2%) of 9 patients who executed planned discontinuation achieved TFR within 12 months. In the first 6 months, the detection rate of BCR/ABL transcripts by dd-PCR was higher than that by RT-qPCR and the two methods kept a positive correlation (r=0.9651, P=0.0349). Meanwhile, the time of detectable BCR/ABL by dd-PCR were significantly shorter (P<0.05), which was an average of 2.98 months earlier than RT-qPCR. The total TKI therapy and MR4.5 duration time related with TFR were longer in patients with intermediate or high Sokal risk scores (p<0.05). The dd-PCR could be more sensitive than RT-qPCR for monitoring BCR/ABL transcripts of CML patients with deep molecular response to TKI. The technique can be used as a preferred method to detect the transcripts in the first 6 months after TKI cessation.

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