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Volume 26
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Communication

No Benefit from Hydroxyurea Pre-Treatment in Frontline Chronic Myeloid Leukemia Therapy and Evidence of Quantitative Changes in the BCR::ABL1 Transcript Level

by
Fabio Stagno
1,*,†,
Stefania Stella
2,3,†,
Salvatore Leotta
4,
Santino Caserta
1,
Silvia Rita Vitale
2,3,
Uros Markovic
4,
Cristina Tomarchio
2,3,
Giuseppe Mirabile
1,
Sabina Russo
1,
Michele Massimino
3,5,
Paolo Vigneri
2,6,
Livia Manzella
2,3,
Francesco Di Raimondo
4,5,‡ and
Alessandro Allegra
1,‡
1
Hematology Section, A.O.U. Policlinico “G. Martino”, University of Messina, 98100 Messina, Italy
2
Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
3
Center of Experimental Oncology and Hematology, A.O.U. Policlinico “Rodolico-San Marco”, 95123 Catania, Italy
4
Hematology and BMT Unit, A.O.U. Policlinico “Rodolico-San Marco”, University of Catania, 95123 Catania, Italy
5
Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy
6
University Oncology Department, Humanitas Istituto Clinico Catanese, 95045 Catania, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work and shared the co-first authors.
‡
These authors contributed equally to this work and shared the co-last authors.
Int. J. Mol. Sci. 2025, 26(5), 1840; https://doi.org/10.3390/ijms26051840
Submission received: 23 December 2024 / Revised: 18 February 2025 / Accepted: 18 February 2025 / Published: 21 February 2025
(This article belongs to the Special Issue Molecular Biology and Targeted Therapies in Leukemias)
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Abstract

Hydroxyurea (HU) cytoreduction is usually administered to patients with chronic myeloid leukemia before starting any tyrosine kinase inhibitors (TKIs) therapy. However, up to date, there is no evidence of any benefit of hydroxyurea pre-treatment. Conversely, evidence has been provided on both the prognostic significance of the quantitative assessment of BCR::ABL1 expression at diagnosis and the individual decline of the BCR::ABL1 slope. In this view, we assumed that any kind of treatment administered before a confirmed diagnosis of chronic myeloid leukemia might change the amount of BCR::ABL1 transcript levels. To this purpose, we evaluated leukocyte counts and BCR::ABL1 quantitative expression either at diagnosis (baseline and no therapy) and on day 7 and day 14 of treatment in a cohort of 45 unselected patients with newly diagnosed chronic myeloid leukemia in the chronic phase. After informed consent, 21 of them received HU cytoreduction for 14 days before starting TKI treatment (HU group), whereas the other 24 patients received frontline TKI therapy without HU pre-treatment (TKI group). Our findings showed that: (i) there is no benefit from HU cytoreduction in patients affected with chronic myeloid leukemia before starting treatment with TKIs; (ii) any kind of therapy administered before a confirmed diagnosis of chronic myeloid leukemia might change the amount of BCR::ABL1 expression levels.
Keywords: chronic myeloid leukemia; CML; CML therapy; hydroxyurea; BCR::ABL1; BCR::ABL1/ABL1 transcript; TKI; HU chronic myeloid leukemia; CML; CML therapy; hydroxyurea; BCR::ABL1; BCR::ABL1/ABL1 transcript; TKI; HU

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MDPI and ACS Style

Stagno, F.; Stella, S.; Leotta, S.; Caserta, S.; Vitale, S.R.; Markovic, U.; Tomarchio, C.; Mirabile, G.; Russo, S.; Massimino, M.; et al. No Benefit from Hydroxyurea Pre-Treatment in Frontline Chronic Myeloid Leukemia Therapy and Evidence of Quantitative Changes in the BCR::ABL1 Transcript Level. Int. J. Mol. Sci. 2025, 26, 1840. https://doi.org/10.3390/ijms26051840

AMA Style

Stagno F, Stella S, Leotta S, Caserta S, Vitale SR, Markovic U, Tomarchio C, Mirabile G, Russo S, Massimino M, et al. No Benefit from Hydroxyurea Pre-Treatment in Frontline Chronic Myeloid Leukemia Therapy and Evidence of Quantitative Changes in the BCR::ABL1 Transcript Level. International Journal of Molecular Sciences. 2025; 26(5):1840. https://doi.org/10.3390/ijms26051840

Chicago/Turabian Style

Stagno, Fabio, Stefania Stella, Salvatore Leotta, Santino Caserta, Silvia Rita Vitale, Uros Markovic, Cristina Tomarchio, Giuseppe Mirabile, Sabina Russo, Michele Massimino, and et al. 2025. "No Benefit from Hydroxyurea Pre-Treatment in Frontline Chronic Myeloid Leukemia Therapy and Evidence of Quantitative Changes in the BCR::ABL1 Transcript Level" International Journal of Molecular Sciences 26, no. 5: 1840. https://doi.org/10.3390/ijms26051840

APA Style

Stagno, F., Stella, S., Leotta, S., Caserta, S., Vitale, S. R., Markovic, U., Tomarchio, C., Mirabile, G., Russo, S., Massimino, M., Vigneri, P., Manzella, L., Di Raimondo, F., & Allegra, A. (2025). No Benefit from Hydroxyurea Pre-Treatment in Frontline Chronic Myeloid Leukemia Therapy and Evidence of Quantitative Changes in the BCR::ABL1 Transcript Level. International Journal of Molecular Sciences, 26(5), 1840. https://doi.org/10.3390/ijms26051840

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