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Circulating miR-146a expression predicts early treatment response to imatinib in adult chronic myeloid leukemia
  1. Eman M Habib1,
  2. Nahla A Nosiar1,
  3. Manal A Eid2,
  4. Atef M Taha3,
  5. Dalia E Sherief1,
  6. Asmaa E Hassan1,
  7. Muhammad Tarek Abdel Ghafar2
  1. 1 Clinical Pathology, Kafr el-Sheikh University, Kafr el-Sheikh, Egypt
  2. 2 Clinical Pathology, Tanta University Faculty of Medicine, Tanta, Egypt
  3. 3 Internal Medicine, Tanta University Faculty of Medicine, Tanta, Egypt
  1. Correspondence to Dr Eman M Habib, Clinical Pathology, Faculty of Medicine, Kafr el-Sheikh University, Kafr el-Sheikh, Egypt; eman.habeeb{at}; Dr Muhammad Tarek Abdel Ghafar, Clinical Pathology Department, Faculty of Medicine-Tanta University, Tanta, Egypt; mohammedtarek5514{at}


This study aimed to investigate the prognostic role of circulating miR-146a in the prediction of early response to imatinib treatment in patients with chronic myeloid leukemia (CML). Sixty patients with CML and 20 healthy controls were recruited in this study. BCR-ABL was assessed by quantitative rt-PCR at days 0 and 90 of imatinib therapy. Circulating miR-146a levels were assessed by quantitative rt-PCR at days 0, 14 and 90 of imatinib therapy for patients and once for controls. At day 90 of treatment, treatment response was achieved in 48 patients (80.0%). Responders had significantly lower baseline Sokal score when compared with non-responders. They also had significantly lower BCR-ABL expression at day 90 of treatment. The circulating miR-146a level was significantly lower in patients with CML than in healthy subjects and showed a significant rise after 14 days of imatinib treatment and an inverse correlation with BCR-ABL expression levels at 90 days. Using multivariate logistic regression analysis, baseline BCR-ABL (%) (OR (95% CI) 1.09 (1.03 to 1.016), p=0.006) and miR-146a at 14 days (OR (95% CI) 0.002 (0.0 to 0.09), p=0.001) were significant predictors of treatment response. Using ROC curve analysis, it was found that miR-146a expression at 14 and 90 days could distinguish responders from non-responders (AUC (95% CI) 0.849 (0.733 to 0.928) and 0.867 (0.755 to 0.941), respectively). This study reported for the first time that measurement of the circulating miR-146a expression at 14 days can predict the early response to imatinib treatment in patients with CML. Thus, this work indicates that miR-146a should be investigated in the setting of treatment response to other tyrosine kinase inhibitors.

  • leukemia
  • myeloid
  • acute
  • RNA
  • biomarkers

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  • Contributors EMH, MAE, MTAG, DES, AEH, NAN: study designing, retrieving the literature, performing routine and molecular investigations, analyzing data. AMT: patients’ selection and follow-up. All authors: writing the original draft, reviewing and final manuscript approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.