The Efficacy Of Tki In Patients With Different Bcr/Abl Transcript Types Of Chronic Myeloid Leukemia: A Systematic Review And Meta-Analysis

There was controversy about the efficacy of tyrosine kinase inhibitor (TKI) in the treatment of different transcripts. Some reported that the e14a2 transcript performing TKI treatment showed much better efficacy, however, other studies did not come to consistent results. In order to estimate the efficacy of TKI in patients with different BCR/ABL transcript types of chronic myeloid leukemia (CML), we searched published articles or internationally accepted abstracts from PubMed, Embase, Medline, Cochrane library, China Knowledge Network (CNKI), Chinese Biomedical Abstracts Database (CBM), Wanfang Database and Chinese Veterinary Science Database (VIP) before January 2019. Data such as stage, the BCR/ABL transcript type, use of TKI drugs, the rate of major molecular response (MMR), the rate of complete cytogenetic response (CCyR) and the rate of 5-year overall survival (OS) were extracted from each included study. Of 2768 citations, 16 clinical trials were selected and included in the review. Results revealed that the 6-month MMR rate and long-term MMR rate in the e13a2 group were much lower than that in the e14a2 group after TKI treatment. The 5-year OS rate in the e13a2 group was lower than that in the e14a2 group. In addition, the 12-month CCyR rate in the e13a2 group was also lower than that in the e14a2 group. However, the 6-month CCyR rate had no significant difference between e13a2 group and e14a2 group. Therefore, we believed that the 6-month MMR rate, the long-term MMR rate, the 5-year OS rate and the 12-month CCyR rate were correlated with the BCR/ABL transcript in patients with CML after TKI treatment. The e14a2 transcript performing TKI treatment showed much better efficacy.