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      Clinicopathological Variables and Outcome in Chronic Myeloid Leukemia Associated With BCR-ABL1 Transcript Type and Body Weight: An Outcome of European LeukemiaNet Project

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          Abstract

          Objective

          It is debatable whether BCR-ABL1 transcript type has an impact on outcome of treatment of patients with CML, and it is not widely studied whether body weight influences response to treatment. In this study, we tried to find out if any of these factors has an impact on response to treatment and outcome.

          Methodology

          We conducted a retrospective analysis of the files of 79 patients being treated in our center for CML with known BCR-ABL1 breakpoints, and patients’ management and response assessment was done based on ELN 2013 guidelines. The analysis was performed based on two main groups, obese vs. normal BMI, and then based on BCR-ABL1 transcripts: e13a2 vs. e14a2. Cumulative incidence of MMR, CCyR, and DMR were estimated using the Kaplan–Meier survival curve method, and comparisons between groups were performed by the Log-rank/Gray test methods.

          Results/conclusion

          In the patient-cohort studied, there was no statistically significant difference in molecular response between patients with CML based on body weight or transcript type although patients in the obesity group achieved higher and faster MMR with no statistical significance.

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          Most cited references33

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          Cancer Statistics, 2017.

          Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data were collected by the National Center for Health Statistics. In 2017, 1,688,780 new cancer cases and 600,920 cancer deaths are projected to occur in the United States. For all sites combined, the cancer incidence rate is 20% higher in men than in women, while the cancer death rate is 40% higher. However, sex disparities vary by cancer type. For example, thyroid cancer incidence rates are 3-fold higher in women than in men (21 vs 7 per 100,000 population), despite equivalent death rates (0.5 per 100,000 population), largely reflecting sex differences in the "epidemic of diagnosis." Over the past decade of available data, the overall cancer incidence rate (2004-2013) was stable in women and declined by approximately 2% annually in men, while the cancer death rate (2005-2014) declined by about 1.5% annually in both men and women. From 1991 to 2014, the overall cancer death rate dropped 25%, translating to approximately 2,143,200 fewer cancer deaths than would have been expected if death rates had remained at their peak. Although the cancer death rate was 15% higher in blacks than in whites in 2014, increasing access to care as a result of the Patient Protection and Affordable Care Act may expedite the narrowing racial gap; from 2010 to 2015, the proportion of blacks who were uninsured halved, from 21% to 11%, as it did for Hispanics (31% to 16%). Gains in coverage for traditionally underserved Americans will facilitate the broader application of existing cancer control knowledge across every segment of the population. CA Cancer J Clin 2017;67:7-30. © 2017 American Cancer Society.
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            European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013.

            Advances in chronic myeloid leukemia treatment, particularly regarding tyrosine kinase inhibitors, mandate regular updating of concepts and management. A European LeukemiaNet expert panel reviewed prior and new studies to update recommendations made in 2009. We recommend as initial treatment imatinib, nilotinib, or dasatinib. Response is assessed with standardized real quantitative polymerase chain reaction and/or cytogenetics at 3, 6, and 12 months. BCR-ABL1 transcript levels ≤10% at 3 months, 10% at 6 months and >1% from 12 months onward define failure, mandating a change in treatment. Similarly, partial cytogenetic response (PCyR) at 3 months and complete cytogenetic response (CCyR) from 6 months onward define optimal response, whereas no CyR (Philadelphia chromosome-positive [Ph+] >95%) at 3 months, less than PCyR at 6 months, and less than CCyR from 12 months onward define failure. Between optimal and failure, there is an intermediate warning zone requiring more frequent monitoring. Similar definitions are provided for response to second-line therapy. Specific recommendations are made for patients in the accelerated and blastic phases, and for allogeneic stem cell transplantation. Optimal responders should continue therapy indefinitely, with careful surveillance, or they can be enrolled in controlled studies of treatment discontinuation once a deeper molecular response is achieved.
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              A New Consistent Chromosomal Abnormality in Chronic Myelogenous Leukaemia identified by Quinacrine Fluorescence and Giemsa Staining

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                Author and article information

                Journal
                Cancer Control
                spccx
                CCX
                Cancer Control : Journal of the Moffitt Cancer Center
                SAGE Publications (Sage CA: Los Angeles, CA )
                1073-2748
                1526-2359
                18 November 2021
                Jan-Dec 2021
                : 28
                : 10732748211038429
                Affiliations
                [1 ]Department of Medical Oncology, Hematology Section, National Center for Cancer Care and Research, Ringgold 36977, universityHamad Medical Corporation; , Doha, Qatar
                [2 ]Medical Research Center, Biostatistics Section, Ringgold 36977, universityHamad Medical Corporation; , Doha, Qatar
                [3 ]Department of Laboratory Medicine and Pathology, Ringgold 36977, universityHamad Medical Corporation; , Doha, Qatar
                [4 ]Department of Internal Medicine, Ringgold 36977, universityHamad Medical Corporation; , Doha, Qatar
                [5 ]Department of Nursing, Hazm Mebaireek General Hospital, Ringgold 36977, universityHamad Medical Corporation; , Doha, Qatar
                [6 ]University of Verona, Verona, Italy
                [7 ]Ohio State University, Columbus, Ohio, USA
                Author notes
                [*]Mohamed A Yassin MBBS, CABM, MSC, FACP, MSC, Consultant Hematologist and Associate Professor of Medicine National Center for Cancer Care and Research, Qatar University/College of Medicine, Hamad Medical Corporation, Alrayyan Street, Doha 3050, Qatar. Email: yassinmoha@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-1144-8076
                Article
                10.1177_10732748211038429
                10.1177/10732748211038429
                8619745
                34789006
                61e51b07-d73b-4887-96ac-27c6b1377ad6
                © The Author(s) 2021

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Categories
                Original Research Article
                Custom metadata
                January-December 2021
                ts10

                chronic myeloid leukemia,bcr-abl1 transcript,obesity

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