Breccia Massimo, Molica Matteo, Colafigli Gioia, Massaro Fulvio, Alimena Giuliana
Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy.
Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy.
Leuk Res. 2016 Sep;48:20-5. doi: 10.1016/j.leukres.2016.06.010. Epub 2016 Jul 1.
Achieving a BCR-ABL/ABL ratio <10% at 3 months has become an important goal of treatment for chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors. Several evidences showed that this early molecular response (EMR) is associated with positive long-term outcome in terms of overall survival and progression-free survival, but a consensus has not been reached when this goal is not achieved. European LeukemiaNet recommendations defined patients as treatment failure only after the 6- month time point. Not all patients that lack EMR have similar outcome and it became important to identify patients before this time point of 3 months. Several groups introduced the concept of "halving time" or "velocity of ratio reduction" that could anticipate the possibility to recognize patients deserving a switch to another treatment. Aim of this review is to summarize all evidences reported on the significance of EMR and how this evaluation changed our perspectives and modified our therapeutic strategies.
对于接受酪氨酸激酶抑制剂治疗的慢性髓性白血病（CML）患者，在3个月时实现BCR-ABL/ABL比值<10%已成为治疗的一个重要目标。多项证据表明，这种早期分子反应（EMR）在总生存期和无进展生存期方面与良好的长期预后相关，但当未达到这一目标时，尚未达成共识。欧洲白血病网络（European LeukemiaNet）的建议将患者仅在6个月时间点后定义为治疗失败。并非所有缺乏EMR的患者都有相似的预后，在3个月这个时间点之前识别患者变得很重要。几个研究小组引入了“减半时间”或“比值降低速度”的概念，这可以预测识别出值得更换为另一种治疗的患者的可能性。本综述的目的是总结关于EMR意义的所有报道证据，以及这种评估如何改变了我们的观点并调整了我们的治疗策略。
