Characteristics and outcome of chronic myeloid leukemia patients with E255K/V BCR–ABL kinase domain mutations

Kiran Naqvi, Jorge E. Cortes, Raja Luthra, Susan O’Brien, William Wierda, Gautam Borthakur, Tapan Kadia, Guillermo Garcia-Manero, Farhad Ravandi, Mary Beth Rios, Sara Dellasala, Sherry Pierce, Elias Jabbour, Keyur Patel, Hagop Kantarjian

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Kinase domain (KD) mutations of ABL1 represent the most common resistance mechanism to tyrosine kinase inhibitors (TKI) in CML. Besides T315I, mutations in codon 255 are highly resistant mutations in vitro to all TKI. We aimed to study the incidence, prognosis, and response to treatment in patients with E255K/V. We evaluated 976 patients by sequencing of BCR–ABL1 fusion transcript for ABL1 KD mutations. We identified KD mutations in 381 (39%) patients, including E255K/V in 48 (13% of all mutations). At mutation detection, 14 patients (29%) were in chronic phase (CP), 12 (25%) in accelerated phase (AP), and 22 (46%) in blast phase (BP). 9/14 CP patients responded to treatment (best response complete hematologic response—CHR-4; complete cytogenetic response—CCyR-1; major molecular response—MMR-4); only 4/12 AP patients (CHR 3; MMR 1) and 7/22 BP patients responded (CCyR 2; MMR 2; partial cytogenetic response—PCyR-3). After a median follow-up of 65 months from mutation detection, 36 patients (75%) died: 9/14 (64%) in CP, 9/12 (75%) in AP, and 18/22 (82%) in BP (p = 0.003); median overall survival was 12 months. Patients with E255K/V mutation have a poor prognosis, regardless of the stage of the disease at detection.

Original languageEnglish (US)
Pages (from-to)689-695
Number of pages7
JournalInternational Journal of Hematology
Issue number6
StatePublished - Jun 1 2018
Externally publishedYes


  • Chronic myeloid leukemia
  • Mutation
  • Resistance

ASJC Scopus subject areas

  • Hematology


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