The Efficacy Of Tyrosine Kinase Inhibitor In Patients With Different Bcr/abl Transcript Types Of Chronic Myeloid Leukemia:A Meta-analysis

Objective: To estimate the efficacy of tyrosine kinase inhibitor(TKI)in patients with different BCR/ABL transcript types of chronic myeloid leukemia(CML).Methods: Published articles were searched from Pub Med,Embase,Medline,Cochrane library,China Knowledge Network(CNKI),Chinese Biomedical Abstracts Database(CBM),Wanfang Database and Chinese Veterinary Science Database(VIP)before January 2019,and 16 of them were included after a detailed review of each study.Data such as the first author,country,sample,the BCR/ABL transcript type,TKI drug used,the rate of major molecular response(MMR),the rate of complete cytogenetic response(CCy R)and the rate of 5-year overall survival(OS)were extracted from each included study.Meta-analyses were performed using Revman 5.3.Results: 16 clinical trials were selected and included in the review.Results revealed that the 6-month MMR and long-term rate of MMR(the rate of patients with the time to achieve MMR more than 12 months)in e13a2 group were lower than that in e14a2 group after TKI treatment respectively(6-month MMR,RR=0.69,95%CI: 0.59-0.80,P<0.00001;long-term rate of MMR,RR=0.76,95% CI: 0.70-0.84,P<0.00001).The rate of 5-year OS in the e13a2 group was lower than that in the e14a2 group(RR=0.95,95%CI: 0.92-0.98,P=0.0007).The 12-month CCy R rate in the e13a2 group was lower than that in the e14a2 group(RR =0.81,95%CI: 0.65-1.00,P=0.05).However,the estimated 6-month CCy R rate were not statistically significant between e13a2 group and e14a2 group(RR=0.99,95%CI: 0.86-1.14,P=0.93).Conclusion: The e14a2 transcript undergoing TKI treatment showed a better rate of 6-month MMR,long-term rate of MMR,5-year OS and 12-month CCy R,and 6-month CCy R rate were not statistically significant between e13a2 group and e14a2 group.