Additional chromosome abnormalities, BCR-ABL tyrosine kinase domain mutations and clinical outcome in Hungarian tyrosine kinase inhibitor-resistant chronic myelogenous leukemia patients

Nóra Meggyesi, András Kozma, Gabriella Halm, Sarolta Nahajevszky, Árpád Bátai, Sándor Fekete, Anikó Barta, György Ujj, Sándor Lueff, Andrea Sipos, Emma Ádám, András Bors, Péter Reményi, T. Masszi, A. Tordai, H. Andrikovics

Research output: Contribution to journalArticle

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Abstract

Background: Additional chromosome abnormalities (ACAs), mutations of the BCR-ABL tyrosine kinase domain (TKD) and BCR-ABL splice variants may cause resistance to first- and second-generation tyrosine kinase inhibitors (TKIs) in chronic myelogenous leukemia (CML) and Philadelphia-positive (Ph+) acute lymphoid leukemia (ALL). Methods: Karyotyping and BCR-ABL TKD mutation screening were performed in 71 imatinib-resistant CML patients and 6 Ph+ ALL patients. A total of 56 out of these 77 patients received second-generation TKI. Results: ACAs were present in 30 of 65 imatinib-resistant patients (46%). In 27 of 74 imatinib-resistant patients (36%), 15 different BCR-ABL TKD mutations were detected. Mutations were found in 25% of chronic-phase patients (12/47), 33% of accelerated-phase patients (5/15), 71% of blast crisis CML patients (5/7) and 100% of ALL patients. In nilotinib-resistant patients, Y253H, T315I and F359I/V mutations were detected; in dasatinib-resistant patients, L248M, E279K and T315I mutations were detected. T315I was found more frequently in patients on dasatinib than on imatinib therapy. The presence of ACAs predicted shorter survival during first- and second-generation TKI therapy, while TKD mutations only influenced survival during second-generation TKI therapy. Conclusion: For patients with TKI resistance, mutation and ACA screening may play a role in identifying patients with poorer prognosis.

Original languageEnglish
Pages (from-to)34-42
Number of pages9
JournalActa Haematologica
Volume127
Issue number1
DOIs
Publication statusPublished - Dec 2011

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Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Chromosome Aberrations
Protein-Tyrosine Kinases
Mutation
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Blast Crisis
Karyotyping
Survival
Therapeutics

Keywords

  • Additional chromosome abnormalities
  • BCR-ABL
  • Chronic myelogenous leukemia
  • Mutation
  • Tyrosine kinase inhibitor resistance

ASJC Scopus subject areas

  • Hematology

Cite this

Additional chromosome abnormalities, BCR-ABL tyrosine kinase domain mutations and clinical outcome in Hungarian tyrosine kinase inhibitor-resistant chronic myelogenous leukemia patients. / Meggyesi, Nóra; Kozma, András; Halm, Gabriella; Nahajevszky, Sarolta; Bátai, Árpád; Fekete, Sándor; Barta, Anikó; Ujj, György; Lueff, Sándor; Sipos, Andrea; Ádám, Emma; Bors, András; Reményi, Péter; Masszi, T.; Tordai, A.; Andrikovics, H.

In: Acta Haematologica, Vol. 127, No. 1, 12.2011, p. 34-42.

Research output: Contribution to journalArticle

Meggyesi, Nóra ; Kozma, András ; Halm, Gabriella ; Nahajevszky, Sarolta ; Bátai, Árpád ; Fekete, Sándor ; Barta, Anikó ; Ujj, György ; Lueff, Sándor ; Sipos, Andrea ; Ádám, Emma ; Bors, András ; Reményi, Péter ; Masszi, T. ; Tordai, A. ; Andrikovics, H. / Additional chromosome abnormalities, BCR-ABL tyrosine kinase domain mutations and clinical outcome in Hungarian tyrosine kinase inhibitor-resistant chronic myelogenous leukemia patients. In: Acta Haematologica. 2011 ; Vol. 127, No. 1. pp. 34-42.
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AU - Meggyesi, Nóra

AU - Kozma, András

AU - Halm, Gabriella

AU - Nahajevszky, Sarolta

AU - Bátai, Árpád

AU - Fekete, Sándor

AU - Barta, Anikó

AU - Ujj, György

AU - Lueff, Sándor

AU - Sipos, Andrea

AU - Ádám, Emma

AU - Bors, András

AU - Reményi, Péter

AU - Masszi, T.

AU - Tordai, A.

AU - Andrikovics, H.

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N2 - Background: Additional chromosome abnormalities (ACAs), mutations of the BCR-ABL tyrosine kinase domain (TKD) and BCR-ABL splice variants may cause resistance to first- and second-generation tyrosine kinase inhibitors (TKIs) in chronic myelogenous leukemia (CML) and Philadelphia-positive (Ph+) acute lymphoid leukemia (ALL). Methods: Karyotyping and BCR-ABL TKD mutation screening were performed in 71 imatinib-resistant CML patients and 6 Ph+ ALL patients. A total of 56 out of these 77 patients received second-generation TKI. Results: ACAs were present in 30 of 65 imatinib-resistant patients (46%). In 27 of 74 imatinib-resistant patients (36%), 15 different BCR-ABL TKD mutations were detected. Mutations were found in 25% of chronic-phase patients (12/47), 33% of accelerated-phase patients (5/15), 71% of blast crisis CML patients (5/7) and 100% of ALL patients. In nilotinib-resistant patients, Y253H, T315I and F359I/V mutations were detected; in dasatinib-resistant patients, L248M, E279K and T315I mutations were detected. T315I was found more frequently in patients on dasatinib than on imatinib therapy. The presence of ACAs predicted shorter survival during first- and second-generation TKI therapy, while TKD mutations only influenced survival during second-generation TKI therapy. Conclusion: For patients with TKI resistance, mutation and ACA screening may play a role in identifying patients with poorer prognosis.

AB - Background: Additional chromosome abnormalities (ACAs), mutations of the BCR-ABL tyrosine kinase domain (TKD) and BCR-ABL splice variants may cause resistance to first- and second-generation tyrosine kinase inhibitors (TKIs) in chronic myelogenous leukemia (CML) and Philadelphia-positive (Ph+) acute lymphoid leukemia (ALL). Methods: Karyotyping and BCR-ABL TKD mutation screening were performed in 71 imatinib-resistant CML patients and 6 Ph+ ALL patients. A total of 56 out of these 77 patients received second-generation TKI. Results: ACAs were present in 30 of 65 imatinib-resistant patients (46%). In 27 of 74 imatinib-resistant patients (36%), 15 different BCR-ABL TKD mutations were detected. Mutations were found in 25% of chronic-phase patients (12/47), 33% of accelerated-phase patients (5/15), 71% of blast crisis CML patients (5/7) and 100% of ALL patients. In nilotinib-resistant patients, Y253H, T315I and F359I/V mutations were detected; in dasatinib-resistant patients, L248M, E279K and T315I mutations were detected. T315I was found more frequently in patients on dasatinib than on imatinib therapy. The presence of ACAs predicted shorter survival during first- and second-generation TKI therapy, while TKD mutations only influenced survival during second-generation TKI therapy. Conclusion: For patients with TKI resistance, mutation and ACA screening may play a role in identifying patients with poorer prognosis.

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