Chronic Myeloid Leukemia Coverage from Every Angle

Achievement of Treatment-Free Remission in CML Influenced by Transcript Variant

By: Sarah Campen, PharmD
Posted: Tuesday, February 19, 2019

For patients with chronic myeloid leukemia (CML), discontinuing treatment with tyrosine kinase inhibitors (TKIs) has become a realistic goal. However, researchers in Italy have discovered that patients with the e13a2 BCR-ABL transcript variant may be significantly less likely to achieve treatment-free remission than patients with the e14a2 variant. The results of their research were published in Cancer.

“The current data support the hypothesis that the e13a2 BCR-ABL transcript confers decreased sensitivity to treatment with TKI inhibitors, significantly reducing the possibility of achieving a [deep molecular response] and of maintaining it for more than 2 years,” stated Mariella D’Adda, MD, of the Local Social Health Authority (ASST) Spedali Civili Brescia, Brescia, Italy, and colleagues, “ultimately compromising the goal of achieving a [treatment-free remission].”

In this retrospective study of 173 patients, 67 (38.7%) had the e13a2 transcript and 106 patients (61.3%) had the e14a2 transcript. The achievement of both a deep molecular response (P = .008) and a sustained deep molecular response (P = .004) was favored significantly in those with the e14a2 transcript. After a median of 68 months, the sustained deep molecular response rate was 39.6% in patients with the e14a2 transcript compared with 19.4% in those with the e13a2 transcript.

Transcript type also seemed to influence maintenance of treatment-free remission (P = .005), as just 2 patients (3%) with the e13a2 transcript achieved a durable treatment-free remission compared with 25 patients (23.5%) with the e14a2 transcript. Based on these results, the authors concluded that the transcript type “should be added to the list of prognostic factors that have been associated with a higher risk of [treatment-free remission] failure.”

Disclosure: The study authors’ disclosure information may be found at

By continuing to browse this site you permit us and our partners to place identification cookies on your browser and agree to our use of cookies to identify you for marketing. Read our Privacy Policy to learn more.