Monitoring CML patients responding to treatment with tyrosine kinase inhibitors:: review and recommendations for harmonizing current methodology for detecting BCR-ABL transcripts and kinase domain mutations and for expressing results

被引:899
作者
Hughes, Timothy
Deininger, Michael
Hochhaus, Andreas
Branford, Susan
Radich, Jerald
Kaecla, Jaspal
Baccarani, Michele
Cortes, Jorge
Cross, Nicholas C. P.
Druker, Brian J.
Gabert, Jean
Grimwade, David
Hehlmann, Ruediger
Kamel-Reid, Suzanne
Lipton, Jeffrey H.
Longtine, Janina
Martinelli, Giovanni
Saglio, Giuseppe
Soverini, Simona
Stock, Wendy
Goldman, John M.
机构
[1] NHLBI, Hematol Branch, NIH, Bethesda, MD 20892 USA
[2] Oregon Hlth & Sci Univ, Inst Canc, Dept Med Hematol Oncol, Portland, OR 97201 USA
[3] Inst Med & Vet Sci, Adelaide, SA 5000, Australia
[4] Heidelberg Univ, Fac Clin Med Mannheim, D-6800 Mannheim, Germany
[5] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA
[6] Hammersmith Hosp, Imperial Coll, Dept Haematol, London, England
[7] Univ Bologna, Inst Hematol & Med Oncol Seragnoli, I-40126 Bologna, Italy
[8] Univ Texas, MD Anderson Canc Ctr, Dept Leukemia, Houston, TX 77030 USA
[9] Univ Southampton, Natl Genet Reference Lab, Salisbury, Wilts, England
[10] Univ Mediterranee, APHM, Marseille, France
[11] Univ Mediterranee, Equipe Rech Technol, Marseille, France
[12] Kings Coll London, Dept Med & Mol Genet, London WC2R 2LS, England
[13] Univ Toronto, Princess Margaret Hosp, Dept Med Oncol & Hematol, Toronto, ON, Canada
[14] Brigham & Womens Hosp, Dept Pathol, Boston, MA 02115 USA
[15] Univ Turin, Dept Clin & Biol Sci, Orbassano, Italy
[16] Univ Chicago, Dept Med, Chicago, IL 60637 USA
关键词
D O I
10.1182/blood-2006-01-0092
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The introduction in 1998 of imatinib mesylate (IM) revolutionized management of patients with chronic myeloid leukemia (CML) and the second generation of tyrosine kinase inhibitors may prove superior to IM. Real-time quantitative polymerase chain reaction (RQ-PCR) provides an accurate measure of the total leukemia-cell mass and the degree to which BCR-ABL transcripts are reduced by therapy correlates with progression-free survival. Because a rising level of BCR-ABL is an early indication of loss of response and thus the need to reassess therapeutic strategy, regular molecular monitoring of individual patients is clearly desirable. Here we summarize the results of a consensus meeting that took place at the National Institutes of Health (NIH) in Bethesda in October 2005. We make suggestions for (1) harmonizing the differing methodologies for measuring BCR-ABL transcripts in patients with CML undergoing treatment and using a conversion factor whereby individual laboratories can express BCR-ABL transcript levels on an internationally agreed scale; (2) using serial RQ-PCR results rather than bone marrow cytogenetics or fluorescence in situ hybridization (FISH) for the BCR-ABL gene to monitor individual patients responding to treatment; and (3) detecting and reporting Philadelphia (Ph) chromosome-positive subpopulations bearing BCR-ABL kinase domain mutations. We recognize that our recommendations are provisional and will require revision as new evidence emerges.
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收藏
页码:28 / 37
页数:10
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