Impact Of BCR-ABL1 Monitoring Among Patients With BCR-ABL1-Positive B-Acute Lymphoblastic Leukemia
Acute lymphoblastic leukaemia (ALL) with BCR-ABL1 confers a high risk of relapse and a poor prognosis. Access to the tyrosine kinase inhibitor as part of the treatment strategy has changed the risk stratification for ALL patients harbouring this fusion gene. As BCR-ABL1 is routinely quantified for t...
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Universiti Sains Islam Malaysia |
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USIM Institutional Repository |
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en_US |
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Cancer research Cancer treatment Hematologic Neoplasms Cancer research |
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Cancer research Cancer treatment Hematologic Neoplasms Cancer research Chong Siew Lian Impact Of BCR-ABL1 Monitoring Among Patients With BCR-ABL1-Positive B-Acute Lymphoblastic Leukemia |
| description |
Acute lymphoblastic leukaemia (ALL) with BCR-ABL1 confers a high risk of relapse and a poor prognosis. Access to the tyrosine kinase inhibitor as part of the treatment strategy has changed the risk stratification for ALL patients harbouring this fusion gene. As BCR-ABL1 is routinely quantified for the monitoring of its myeloproliferative counterpart, incorporation of its quantification by real-time polymerase chain reaction could be a reliable parameter for the monitoring of measurable residual disease (MRD) for ALL with BCR-ABL1. Whether this has replaced conventional risk factors in deciding whether patients would need a transplant or not is yet to be determined. This study aimed to determine the impact of BCR-ABL1 monitoring in patients with ALL with BCR-ABL1 on their outcome after allogeneic stem cell transplantation. We retrospectively analysed the survival outcome of these patients based on the quantification of BCR-ABL1 at three time-points; time-point 1 at the end of induction, time point 2 at post-consolidation week 16, and time point 3 at the end of treatment for patients who were transplant-eligible or nontransplant eligible. From 2006 to 2018, a total of 96 adult patients newly diagnosed with acute lymphoblastic leukemia with BCR-ABL1 were treated with chemotherapy and a tyrosine kinase inhibitor. Thirty-eight (41.3%) achieved overall remission; 33 patients underwent an allogeneic stem cell transplant. Our data showed that residual disease monitoring by real-time quantitative polymerase chain reaction performed prior to transplantation showed the highest survival correlation in ALL with patients with BCR-ABL1, especially for those who underwent allogeneic stem cell transplantation. Patients with MRD negative before transplantation had better survival compared to those who were MRD positive and showed excellent long-term outcomes after allogeneic stem cell transplantation. With the emergence of tyrosine kinase inhibitors and the incorporation of stringent, measurable residual disease monitoring, risk stratification for ALL with BCR-ABL1 has changed significantly. |
| format |
Thesis |
| author |
Chong Siew Lian |
| author_facet |
Chong Siew Lian |
| author_sort |
Chong Siew Lian |
| title |
Impact Of BCR-ABL1 Monitoring Among Patients With BCR-ABL1-Positive B-Acute Lymphoblastic Leukemia |
| title_short |
Impact Of BCR-ABL1 Monitoring Among Patients With BCR-ABL1-Positive B-Acute Lymphoblastic Leukemia |
| title_full |
Impact Of BCR-ABL1 Monitoring Among Patients With BCR-ABL1-Positive B-Acute Lymphoblastic Leukemia |
| title_fullStr |
Impact Of BCR-ABL1 Monitoring Among Patients With BCR-ABL1-Positive B-Acute Lymphoblastic Leukemia |
| title_full_unstemmed |
Impact Of BCR-ABL1 Monitoring Among Patients With BCR-ABL1-Positive B-Acute Lymphoblastic Leukemia |
| title_sort |
impact of bcr-abl1 monitoring among patients with bcr-abl1-positive b-acute lymphoblastic leukemia |
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Universiti Sains Islam Malaysia |
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1812444648312930304 |
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my-usim-ddms-126542024-05-29T18:20:22Z Impact Of BCR-ABL1 Monitoring Among Patients With BCR-ABL1-Positive B-Acute Lymphoblastic Leukemia Chong Siew Lian Acute lymphoblastic leukaemia (ALL) with BCR-ABL1 confers a high risk of relapse and a poor prognosis. Access to the tyrosine kinase inhibitor as part of the treatment strategy has changed the risk stratification for ALL patients harbouring this fusion gene. As BCR-ABL1 is routinely quantified for the monitoring of its myeloproliferative counterpart, incorporation of its quantification by real-time polymerase chain reaction could be a reliable parameter for the monitoring of measurable residual disease (MRD) for ALL with BCR-ABL1. Whether this has replaced conventional risk factors in deciding whether patients would need a transplant or not is yet to be determined. This study aimed to determine the impact of BCR-ABL1 monitoring in patients with ALL with BCR-ABL1 on their outcome after allogeneic stem cell transplantation. We retrospectively analysed the survival outcome of these patients based on the quantification of BCR-ABL1 at three time-points; time-point 1 at the end of induction, time point 2 at post-consolidation week 16, and time point 3 at the end of treatment for patients who were transplant-eligible or nontransplant eligible. From 2006 to 2018, a total of 96 adult patients newly diagnosed with acute lymphoblastic leukemia with BCR-ABL1 were treated with chemotherapy and a tyrosine kinase inhibitor. Thirty-eight (41.3%) achieved overall remission; 33 patients underwent an allogeneic stem cell transplant. Our data showed that residual disease monitoring by real-time quantitative polymerase chain reaction performed prior to transplantation showed the highest survival correlation in ALL with patients with BCR-ABL1, especially for those who underwent allogeneic stem cell transplantation. Patients with MRD negative before transplantation had better survival compared to those who were MRD positive and showed excellent long-term outcomes after allogeneic stem cell transplantation. With the emergence of tyrosine kinase inhibitors and the incorporation of stringent, measurable residual disease monitoring, risk stratification for ALL with BCR-ABL1 has changed significantly. Universiti Sains Islam Malaysia 2021-12 Thesis en_US https://oarep.usim.edu.my/handle/123456789/12654 https://oarep.usim.edu.my/bitstreams/83dbe9d5-4405-4d32-b0ff-6e11976b1561/download e833205ac3f0a80df3d5a43ea6b1b4bc https://oarep.usim.edu.my/bitstreams/652261f0-5b8e-400f-a96e-f21afb0ab30b/download 8eddbafae8aa53c9759880ef475f3520 https://oarep.usim.edu.my/bitstreams/946645cb-38f0-46bb-976f-6183f92f2139/download f831d53ee264e725d2bd378096413067 https://oarep.usim.edu.my/bitstreams/fbae4e9f-bd7b-40d3-950b-d6014caa032b/download 227a0561d509168795d66eee8be30079 https://oarep.usim.edu.my/bitstreams/bf7c4432-eff4-4f6c-a807-8cbe8d384be9/download c7cb374d85dbdaf3bf896d00e8ed6d42 https://oarep.usim.edu.my/bitstreams/0de4d4a7-34b2-4c70-8f23-c00d3f81b18e/download f2e4317dec24247e478a221cab025652 https://oarep.usim.edu.my/bitstreams/da36ff99-b439-47a9-a7e5-a5f979e69a7e/download d24dd5e7b45920681e09a7a4fe656456 https://oarep.usim.edu.my/bitstreams/23773bf2-a773-431a-866e-2e8e94bc6eec/download 6851f411bc8954ebd01d1b7b072508e4 https://oarep.usim.edu.my/bitstreams/af67a61a-ba34-4f01-b6fe-20cafea204cc/download 68b329da9893e34099c7d8ad5cb9c940 https://oarep.usim.edu.my/bitstreams/d42b77d4-60a7-460a-a4d4-37b9b5714e72/download c411e001da8b0972e8394d1756422a5e https://oarep.usim.edu.my/bitstreams/c25f8968-b0c7-4695-a43e-38f24b7a347f/download 0de084e9f6925a92d71ca741c6258db1 https://oarep.usim.edu.my/bitstreams/39b7ef14-1dea-47a1-8655-930e53bf9131/download 774a91416753961e1429a9dd7fa38faa https://oarep.usim.edu.my/bitstreams/bb001d2e-ed93-4ce2-acbf-6e870c4e88d8/download 922bdb259570e1f17d6c0ded5bb52685 https://oarep.usim.edu.my/bitstreams/0d087838-2591-45ce-af6d-17b954c37f82/download 973cb28b605600938ecbc76cd3f3fc7e https://oarep.usim.edu.my/bitstreams/c0b3823d-86a3-4624-b198-a2b315d9dec9/download 988402c155548f4ff42fd2665969f532 https://oarep.usim.edu.my/bitstreams/77590db6-30b7-4172-a003-6b42f279f489/download 9bdb7fc4ff58c212c9a51b71cb167d3c https://oarep.usim.edu.my/bitstreams/03b0a5ea-6f93-4c13-94fb-69f30b728c09/download 8a4605be74aa9ea9d79846c1fba20a33 Cancer research Cancer treatment Hematologic Neoplasms Acute lymphoblastic leukaemia (ALL), BCR-ABL1 |