Publication details

Role of treatment in the appearance and selection of BCR-ABL1 kinase domain mutations

Authors

RÁZGA Filip JURČEK Tomáš ŽÁČKOVÁ Daniela DVOŘÁKOVÁ Dana TOŠKOVÁ Martina JEŽÍŠKOVÁ Ivana MAYER Jiří RÁČIL Zdeněk

Year of publication 2012
Type Article in Periodical
Magazine / Source Molecular diagnosis and therapy
MU Faculty or unit

Faculty of Medicine

Citation
Field Oncology and hematology
Keywords BCR-ABL1; gene mutations; CML
Attached files
Description Our data show that pretreatment with non-specific non-TKI drugs prior to TKI therapy does not preferentially select for initial BCR-ABL1 KD mutations, in contrast to first-line imatinib therapy, which shows a clear predominance of T315I or P-loop mutations compared with mutations located in other KD regions. In addition, the median time to detection of P-loop mutations was substantially shorter in patients treated with first-line imatinib than in those pretreated with non-TKI drugs. Furthermore, analysis of CML patients who had recurrent resistance to TKI therapy revealed possible therapy-driven selection of BCRABL1 KD mutations. Finally, we confirm the previously described poor prognosis of CML patients with mutations in the BCR-ABL1 KD, since 40.0% of our CML patients who harbored a BCR-ABL1 KD mutation died from CML while receiving TKI treatment. Moreover, among the patients who are still on treatment, 27.8%have already progressed. Our data also confirm the unique position of the T315I mutation with respect to its strong resistance to currently approved TKIs.
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