Clinical evaluation of BCR-ABL peptide immunisation in chronic myeloid leukaemia: results of the EPIC study

Leukemia. 2007 Nov;21(11):2287-95. doi: 10.1038/sj.leu.2404858. Epub 2007 Jul 19.


Peptides from the e14a2 BCR-ABL junction will elicit T-cell responses in vitro. Here, 19 imatinib treated CML patients in first chronic phase were vaccinated with BCR-ABL peptides spanning the e14a2 fusion junction, some of which were linked to the pan DR epitope PADRE to augment CD4+ T cell help. Six vaccinations were given over 9 weeks, together with sargramostim. All patients developed mild local reactions. T cell responses to PADRE were seen in all patients. Fourteen of 19 patients developed T cell responses to BCR-ABL peptides. The development of an anti-BCR-ABL T cell response correlated with a subsequent fall in BCR-ABL transcripts. No molecular benefit was seen in the 5 patients not in major cytogenetic response (MCR) at baseline. However, of the 14 patients in MCR at baseline, 13 developed at least 1 log fall in BCR-ABL transcripts, though this occurred several months after completing vaccination, consistent with an effect at a primitive CML stem cell level. Vaccination may improve the fall in BCR-ABL transcripts in patients who have received imatinib for more than 12 months. BCR-ABL peptide vaccination may improve control of CML, especially in patients responding well to imatinib. Randomised trials are required to address this further.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Agents / pharmacology
  • Benzamides
  • CD4-Positive T-Lymphocytes
  • Cancer Vaccines / chemistry*
  • Cancer Vaccines / metabolism
  • Dendritic Cells / cytology
  • Female
  • Fusion Proteins, bcr-abl / chemistry*
  • Fusion Proteins, bcr-abl / metabolism
  • Humans
  • Imatinib Mesylate
  • Interferon-gamma / metabolism
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / immunology
  • Male
  • Middle Aged
  • Peptides / chemistry*
  • Piperazines / pharmacology
  • Pyrimidines / pharmacology
  • T-Lymphocytes / metabolism


  • Antineoplastic Agents
  • Benzamides
  • Cancer Vaccines
  • Peptides
  • Piperazines
  • Pyrimidines
  • Interferon-gamma
  • Imatinib Mesylate
  • Fusion Proteins, bcr-abl