The prognostic importance of BCR-ABL transcripts in Chronic Myeloid Leukemia: A systematic review and meta-analysis

Impact of BCR-ABL1 Transcript Type on Response, Treatment-Free Remission Rate and Survival in Chronic Myeloid Leukemia Patients Treated with Imatinib

“…In our analysis, the cumulative incidence of cytogenetic and molecular responses during the first 12 months of IM treatment was similar in both groups of patients, with optimal responses at 3 and 6 months being also similar. Nevertheless, we observed a better cumulative incidence of major molecular responses at 6 months in the e14a2 group, comparable to previously reported data, and supporting the concept that this transcript type may be more sensitive to IM [ 3 , 11 , 12 , 30 , 31 ].…”

“…The majority of CML patients have a BCR-ABL1 -p210 with an e13a2 or an e14a2 transcript [ 1 , 21 ]. Previous studies have shown that the e13a2 transcript is more frequent in young men and is associated with a blast crisis of myeloid phenotype [ 8 , 12 , 22 , 23 ]. The e14a2 transcript has been associated with higher platelet count [ 12 , 24 ], while its relationship with lower white cell counts is controversial [ 11 , 12 , 25 ].…”

“…Previous studies have shown that the e13a2 transcript is more frequent in young men and is associated with a blast crisis of myeloid phenotype [ 8 , 12 , 22 , 23 ]. The e14a2 transcript has been associated with higher platelet count [ 12 , 24 ], while its relationship with lower white cell counts is controversial [ 11 , 12 , 25 ]. In our series, we did not observe any of these correlations, not even with sex, age, splenomegaly, or platelet and blast count.…”

“…In the pre-IM era, no differences in outcomes were found between patients with CP-CML expressing the e13a2 or e14a2 transcripts [ 6 , 7 , 8 , 24 , 29 ]. In the IM era, some studies have addressed the influence of the BCR-ABL1 -p210 transcript type with response to IM treatment and CML outcome with controversial results [ 9 , 10 , 11 , 12 ]. Lucas et al [ 2 ] found that the one-year CCyR rate in 78 patients treated with IM 400 mg daily was higher in e14a2 patients than in those with e13a2.…”

“…Some studies carried out prior to the IM era did not find any influence of BCR-ABL1 transcript type on the clinical outcome [ 6 , 7 , 8 ]. However, in the IM era, a Brazilian study, including a small number of patients at different phases of the disease, suggested that patients with the e13a2 transcript were more sensitive to IM in terms of molecular response [ 9 ], whereas other studies with larger number of patients demonstrated a better molecular response to IM in patients with the e14a2 transcript [ 3 , 10 , 11 , 12 ].…”