Standardization and optimization of commercial kit for diagnosis of rearrangements b2a2 and b3a2 of the gene BCR/ABL: discontinuation of tyrosine kinase inhibitor in good prognosis patients with chronic myeloid leukemia

• Grant number: 19/13920-7
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: September 01, 2019
• End date: March 31, 2020
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Gisele Wally Braga Colleoni
• Grantee: Clara Cardoso Franco Avancini
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated research grant: 17/21801-2 - Predictors of severity and new treatments for bone marrow neoplasias, AP.TEM

Abstract

Chronic myeloid leukemia is a myeloproliferative neoplasia which affects middle-aged people. Its physiopathology is related to the existence of a reciprocal translocation between chromosomes 9 and 22, creating a marker chromosome, the Philadelphia (Ph1), and the oncogene BCR-ABL. This gene has tyrosine kinase activity and the treatment is made with inhibitors of the enzime (TKi). Although there is a target therapy, the treatment is lifelong and expensive, what brings up questionings regarding the benefits for the patient and the financial costs. Many studies of treatment interruption with molecular response monitoring have been made in order to discover if it is possible to reach a state of remission so deep that the patient can be asymptomatic at molecular levels and without treatment. Some patients have indeed reached this stage, however monitoring is still a barrier do the TKi interruption as the monthly measurement of the BCR/ABL transcripts by real time PCR (qPCR) is expensive. The goal of this study is to standardize a low cost methodology to perform the RT-PCR at UNIFESP - Hospital São Paulo without the need of third-party services. It will be made through the follow-up of good and intermediate prognosis patients with chronic myeloid leukemia from Hospital São Paulo, who will have the treatment temporarily interrupted and their level of molecular response monthly monitored by RT-PCR for 6 months and then every 3 months until 2 years.