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Therapy adapted to molecular response in patients with chronic myelogenous leukaemia in first chronic phase: results of the Duesseldorf study

This study evaluates response‐adapted treatment of chronic myelogenous leukaemia (CML) in chronic phase using molecular response criteria. bcr‐abl/G6PDH ratios were assessed by Light‐Cycler quantitative real‐time polymerase chain reaction (PCR( in 277 peripheral blood samples from 33 patients, before and every 3 months during therapy. Sixty‐six per cent (22/33) of the patients fulfiled our molecular response criterion of ≥1 log decrease in bcr‐abl transcript after 6 or ≥2 log decrease after 9 and every following 3 months. Dose escalation was necessary for 33% (11/33) of the patients. Of these, 54% (6/11) achieved a reduction of bcr‐abl mRNA by ≥2 log (n = 3) or ≥3 log (n = 3) with 800 mg Imatinib. Forty‐five per cent (5/11) showed insufficient molecular response with 800 mg Imatinib and received Nilotinib. In conclusion, the assessment of molecular response permits an individual patient‐tailored treatment of CML in first chronic phase, resulting in the majority of patients achieving a major molecular response after 2 years of therapy. Copyright © 2008 John Wiley & Sons, Ltd.