The Levels of FoxO3a Predict the Failure of Imatinib Mesylate Therapy among Chronic Myeloid Leukemia Patients


  • Shinta Oktya Wardhani Doctoral Program in Medical Science, Division of Hematology and Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
  • Hani Susanti Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
  • Puji Rahayu Department of Otorhinolaryngology, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
  • Yuyun Yueniwati Department of Radiology, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
  • Jonny Fajar Department of Internal Medicine, Brawijaya Internal Medicine Research Center, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia



FoxO3a, Chronic myeloid leukemia, Treatment response, Treatment failure, Predictors


INTRODUCTION: Forkhead Transcription Factor 3a (FoxO3a) has been proposed to have a high efficacy to predict the failure of imatinib mesylate (IM) therapy among Chronic Myeloid Leukemia (CML) patients. However, the limited evidence had made this marker remained controversy.

OBJECTIVES: We aimed to investigate the correlation between the levels of FoxO3a and the risk of treatment failure of IM therapy in CML patients.

METHODS: A prospective cohort study was carried out between February 2019 and February 2020 in Saiful Anwar Hospital, Malang, Indonesia. All CML patients treated with IM on our hospital during the study period were included. The levels of FoxO3a was determined using the Enzyme-linked immunosorbent assay (ELISA) using Cusabio Biotech Kit (Cusabio Biotech Co., New York, USA). The treatment response was assessed using the European Leukemia criteria. The correlation and effect estimate between the levels of FoxO3a and treatment response of CML patients was assessed using multiple logistic regression.

RESULTS: 53 CML patients receiving IM in our hospital were included, consisting of 29 patients with good response and 24 patients with non-response. Our study found that CML patients with lower levels of FoxO3a was associated with increased risk to develop treatment failure when treated with IM. Moreover, we also found that higher risk of treatment failure of IM therapy was also found in patients with increased levels of thrombocytes, basophils, and leukocytes, and lower levels of hemoglobin.

CONCLUSION: We reveal that FoxO3a is the prominent marker to predict the treatment response of CML patients treated with IM.


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How to Cite

Wardhani SO, Susanti H, Rahayu P, Yueniwati Y, Fajar J. The Levels of FoxO3a Predict the Failure of Imatinib Mesylate Therapy among Chronic Myeloid Leukemia Patients. Open Access Maced J Med Sci [Internet]. 2021 Apr. 29 [cited 2021 Dec. 4];9(B):255-9. Available from:

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