Yang Lan, Cao Li-Xia, Ren Hui-Juan, Han Yan-Qiu
Department of Hematology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1349-1355. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.007.
To investigate the early predictive value of halving time (HT) of for deep molecular response (DMR) in patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitor (TKI).
The continuous data of newly diagnosed CML patients with complete case data and first-line imatinib treatment admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2014 to June 2022 were retrospectively analyzed. Combined with the clinical characteristics of the patients and the efficacy analysis at each time point, a logistic regression model was used to explore the independent influencing factors of DMR, and combined HT of with level at 3 months to predict DMR of the patients.
Univariate and multivariate analyses showed that HT and 3-month levels were independent influencing factors for MR4, MR4.5, and stable MR4.5 ( < 0.05). ROC curve analysis determined that the best cut-off value of HT was 28 days. Compared with patients with HT>28 d, patients with HT≤28 d were more likely to obtain DMR at 2, 3, and 5 years, respectively (74.2% 27.3%, 71.2% 22.7%, and 63.6% 25.0%, all < 0.001). The patients were divided into 4 groups according to levels at 3 months and HT. Kaplan-Meier analysis showed that the patients in the ≤10% and HT≤28 d group had a higher probability of obtaining cumulative MR4 and MR4.5 than those in the ≤10% and HT>28 d group ( < ＜0.05); Patients in the >10% and HT≤28 d group had a higher probability of obtaining cumulative MR4 and MR4.5 than those in the ＞10% and HT>28 d group ( < 0.05).
In addition to level, HT of can be used as another important predictor of treatment efficacy in CML patients. The combination of level and HT has a more accurate predictive value for long-term molecular response of CML patients after TKI treatment.
探讨慢性髓性白血病（CML）患者接受酪氨酸激酶抑制剂（TKI）治疗时，减半时间（HT）对深度分子反应（DMR）的早期预测价值。
回顾性分析2014年1月至2022年6月内蒙古医科大学附属医院收治的新诊断CML患者的完整病例数据及一线伊马替尼治疗的连续数据。结合患者临床特征及各时间点疗效分析，采用逻辑回归模型探讨DMR的独立影响因素，并结合 的HT与3个月时的 水平预测患者的DMR。
单因素和多因素分析显示，HT和3个月时的 水平是MR4、MR4.5和稳定MR4.5的独立影响因素（ < 0.05）。ROC曲线分析确定HT的最佳截断值为28天。与HT>28天的患者相比，HT≤28天的患者在2年、3年和5年时分别更有可能获得DMR（74.2% 对27.3%，71.2% 对22.7%，63.6% 对25.0%，均 < 0.001）。根据3个月时的 水平和HT将患者分为4组。Kaplan-Meier分析显示， ≤10%且HT≤28天组的患者获得累积MR4和MR4.5的概率高于 ≤10%且HT>28天组（ < ＜0.05）；>10%且HT≤28天组的患者获得累积MR4和MR4.5的概率高于 ＞10%且HT>28天组（ < 0.05）。
除 水平外， 的HT可作为CML患者治疗疗效的另一个重要预测指标。 水平与HT的联合对CML患者TKI治疗后的长期分子反应具有更准确的预测价值。
