Disease outcome of the 13 patients in AP with mutations
Patient no. . | Age, y/sex . | Y from diagnosis . | Mutation . | Mo mutation first detected . | Best response by 6 mo . | Status when mutation first detected . | Disease status (mo after imatinib start) . |
|---|---|---|---|---|---|---|---|
| 1 (AP-CE) | 71/F | 4.5 | Gly250Glu | 9 | CHR | PHR | Died from disease progression (12), acquired imatinib resistance |
| Met351Thr | |||||||
| 2 | 41/F | 4.3 | Gln252His (G→C) | 10 | CHR | MBC | Imatinib withdrawn (10), died in MBC after MUD transplantation (15), acquired imatinib resistance |
| 3 (AP-CE) | 62/F | 5.8 | Tyr253Phe | 9 | CHR | CP | Imatinib withdrawn because of loss of CHR (10), died from disease progression (14), acquired imatinib resistance |
| Glu255Val | |||||||
| 4 (AP-CE) | 41/M | 5.3 | Glu255Lys | 6 | CHR | AP | Imatinib withdrawn (6) because of loss of response, died from disease progression (12), acquired imatinib resistance |
| 5 | 60/M | 3.0 | Glu255Lys | 6 | CHR | CP | Lost CP, died from disease progression (8), acquired imatinib resistance |
| 6 (AP-CE) | 44/M | 1.8 | Glu255Lys | 4 | CHR | CP | Died from disease progression (5), acquired imatinib resistance |
| 7 | 60/M | 6.3 | Met351Thr | 6 | CP | CP | Dose increased to 800 mg because of increased WCC (7), dose decreased to 400 mg because of side effects (9), Hydroxyurea commenced because of increased WBC (10), AP (20), acquired imatinib resistance |
| Glu255Lys | 11 | CP | |||||
| Phe359Val | 14 | CP | |||||
| 8 | 61/F | 7.8 | Thr315lle | 9 | CCR | LBC | Died in LBC (9.5), acquired imatinib resistance |
| 9 (AP-CE) | 64/M | 7.8 | Met351Thr | 8 | CHR | CHR | Dose increased to 800 mg (11), MBC (17), mutations not detected at onset of MBC when double Ph-chromosome was present, alive in MBC (20), acquired imatinib resistance |
| Phe359Val | 13 | CHR | |||||
| 10 | 58/F | 1.7 | Met351Thr | 5 | CP | MBC | Died in MBC (10), Acquired imatinib resistance |
| His396Arg | |||||||
| 11 | 48/M | 5.4 | Met351Thr | 5 | CP | AP | Imatinib withdrawn (7) because of MBC, acquired imatinib resistance, died in MBC after autograft (12) |
| 12 | 54/M | 7.5 | Glu355Gly | 12 | CHR | CP | AP (17), proceeded to allograft (23), relapsed into CP, mutation detected after allograft (24), acquired imatinib resistance |
| 13 (AP-CE) | 47/F | 7.7 | Phe486Ser | 9 | CCR | CCR | Lost CCR (17), dose increased to 800 mg, lost MCR (24), acquired imatinib resistance |
Patient no. . | Age, y/sex . | Y from diagnosis . | Mutation . | Mo mutation first detected . | Best response by 6 mo . | Status when mutation first detected . | Disease status (mo after imatinib start) . |
|---|---|---|---|---|---|---|---|
| 1 (AP-CE) | 71/F | 4.5 | Gly250Glu | 9 | CHR | PHR | Died from disease progression (12), acquired imatinib resistance |
| Met351Thr | |||||||
| 2 | 41/F | 4.3 | Gln252His (G→C) | 10 | CHR | MBC | Imatinib withdrawn (10), died in MBC after MUD transplantation (15), acquired imatinib resistance |
| 3 (AP-CE) | 62/F | 5.8 | Tyr253Phe | 9 | CHR | CP | Imatinib withdrawn because of loss of CHR (10), died from disease progression (14), acquired imatinib resistance |
| Glu255Val | |||||||
| 4 (AP-CE) | 41/M | 5.3 | Glu255Lys | 6 | CHR | AP | Imatinib withdrawn (6) because of loss of response, died from disease progression (12), acquired imatinib resistance |
| 5 | 60/M | 3.0 | Glu255Lys | 6 | CHR | CP | Lost CP, died from disease progression (8), acquired imatinib resistance |
| 6 (AP-CE) | 44/M | 1.8 | Glu255Lys | 4 | CHR | CP | Died from disease progression (5), acquired imatinib resistance |
| 7 | 60/M | 6.3 | Met351Thr | 6 | CP | CP | Dose increased to 800 mg because of increased WCC (7), dose decreased to 400 mg because of side effects (9), Hydroxyurea commenced because of increased WBC (10), AP (20), acquired imatinib resistance |
| Glu255Lys | 11 | CP | |||||
| Phe359Val | 14 | CP | |||||
| 8 | 61/F | 7.8 | Thr315lle | 9 | CCR | LBC | Died in LBC (9.5), acquired imatinib resistance |
| 9 (AP-CE) | 64/M | 7.8 | Met351Thr | 8 | CHR | CHR | Dose increased to 800 mg (11), MBC (17), mutations not detected at onset of MBC when double Ph-chromosome was present, alive in MBC (20), acquired imatinib resistance |
| Phe359Val | 13 | CHR | |||||
| 10 | 58/F | 1.7 | Met351Thr | 5 | CP | MBC | Died in MBC (10), Acquired imatinib resistance |
| His396Arg | |||||||
| 11 | 48/M | 5.4 | Met351Thr | 5 | CP | AP | Imatinib withdrawn (7) because of MBC, acquired imatinib resistance, died in MBC after autograft (12) |
| 12 | 54/M | 7.5 | Glu355Gly | 12 | CHR | CP | AP (17), proceeded to allograft (23), relapsed into CP, mutation detected after allograft (24), acquired imatinib resistance |
| 13 (AP-CE) | 47/F | 7.7 | Phe486Ser | 9 | CCR | CCR | Lost CCR (17), dose increased to 800 mg, lost MCR (24), acquired imatinib resistance |
AP-CE indicates the patients with clonal evolution as the sole criterion for AP; MBC, myeloid blast crisis; LBC, lymphoid blast crisis; CHR, complete hematologic response (white blood count [WBC] < 10.0, platelets < 450, no blasts, myelocytes + metamyelocytes. < 5%, no promyelocytes, no disease-related symptoms or extramedullary disease).