Definitions of failure or suboptimal response to imatinib
| Time . | Failure . | Suboptimal response . | Warnings . |
|---|---|---|---|
| Diagnosis | NA | NA | High risk; del(9q+); ACA in Ph-positive cells |
| 3 mo | No HR; stable disease or disease progression | Less than CHR | NA |
| 6 mo | Less than CHR; no cytogenetic response: Ph+ more than 95% | Less than PCyR: Ph+ more than 35% | NA |
| 12 mo | Less than PCyR: Ph+ more than 35% | Less than CCyR | Less than MMR |
| 18 mo | Less than CCyR | Less than MMR | NA |
| Any time | Loss of CHR; loss of CCyR; mutation (eg, T315I) | ACA in Ph+ cells; loss of MMR; mutation | Any rise in transcript level; ACA in Ph-negative cells |
| Time . | Failure . | Suboptimal response . | Warnings . |
|---|---|---|---|
| Diagnosis | NA | NA | High risk; del(9q+); ACA in Ph-positive cells |
| 3 mo | No HR; stable disease or disease progression | Less than CHR | NA |
| 6 mo | Less than CHR; no cytogenetic response: Ph+ more than 95% | Less than PCyR: Ph+ more than 35% | NA |
| 12 mo | Less than PCyR: Ph+ more than 35% | Less than CCyR | Less than MMR |
| 18 mo | Less than CCyR | Less than MMR | NA |
| Any time | Loss of CHR; loss of CCyR; mutation (eg, T315I) | ACA in Ph+ cells; loss of MMR; mutation | Any rise in transcript level; ACA in Ph-negative cells |
Table slightly modified from Baccarani et al.52 The relevance of mutations differs according to the percentage and type of the mutant subclone (see “Defining and managing failure on IM”).
NA, indicates not applicable; ACA, additional chromosomal abnormalities; HR, hematologic response; CHR, complete hematologic response; PCyR, partial cytogenetic response; CCyR, complete cytogenetic response; and MMR, major molecular response.