Jabbour Elias, Kantarjian Hagop, Jones Dan, Breeden Megan, Garcia-Manero Guillermo, O'Brien Susan, Ravandi Farhad, Borthakur Gautam, Cortes Jorge
Department of Leukemia, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Blood. 2008 Jul 1;112(1):53-5. doi: 10.1182/blood-2007-11-123950. Epub 2008 Apr 10.
Chronic myeloid leukemia (CML) with T315I mutation has been reported to have poor prognosis. We analyzed 27 patients with T315I, including 20 who developed T315I after imatinib failure (representing 11% of 186 patients with imatinib failure), and 7 of 23 who developed new mutations after second tyrosine kinase inhibitor (TKI). Median follow-up from mutation detection was 18 months. At the time of T315I detection, 10 were in chronic phase (CP), 9 in accelerated phase, and 8 in blast phase. Except for the lack of response to second TKIs (P = .002), there was no difference in patient characteristics and outcome between patients with T315I and those with other or no mutations. Patients in CP had a 2-year survival rate of 87%. Although the T315I mutation is resistant to currently available TKIs, survival of patients with T315I remains mostly dependent on the stage of the disease, with many CP patients having an indolent course.
据报道，携带T315I突变的慢性髓性白血病（CML）预后较差。我们分析了27例携带T315I突变的患者，其中20例在伊马替尼治疗失败后出现T315I突变（占186例伊马替尼治疗失败患者的11%），23例在使用第二代酪氨酸激酶抑制剂（TKI）后出现新突变的患者中有7例。从检测到突变起的中位随访时间为18个月。在检测到T315I时，10例处于慢性期（CP），9例处于加速期，8例处于急变期。除了对第二代TKI缺乏反应（P = 0.002）外，携带T315I突变的患者与携带其他突变或无突变的患者在患者特征和预后方面没有差异。处于CP期的患者2年生存率为87%。虽然T315I突变对目前可用的TKI耐药，但携带T315I突变患者的生存主要仍取决于疾病分期，许多CP期患者病程进展缓慢。
