{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T03:53:30Z","timestamp":1791604410288,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Deletion and single nucleotide polymorphisms in the BIM gene have been proposed as a potential contributor of intrinsic resistance to imatinib in patients with chronic myeloid leukemia (CML). Individual studies, particularly in East Asian population, have reported higher frequency of these gene variants and have suggested higher resistance rates, however, results remain varied across other non\u2010East Asian cohorts. We aimed to determine the pooled prevalence of BIM deletion and polymorphisms across East Asian and non\u2010East Asian populations and to evaluate their pooled association with imatinib resistance in CML.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A meta\u2010analysis was performed using R Studio 2024.12.0. PubMed, Embase, and Scopus were searched through October 2025. Studies reporting BIM deletion or polymorphisms and imatinib treatment response outcomes in CML patients were included. Random\u2010effects models were applied to estimate pooled prevalence and odds ratios (ORs) for resistance. Subgroup analyses were performed by ethnicity: East Asians versus non\u2010East Asians to compare the differences in prevalence of gene variants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten studies comprising 1,614 CML patients were included. The pooled prevalence of BIM deletion was significantly higher in East Asians (12%, 95% CI: 10%\u201315%) compared to non\u2010East Asians (4%, 95% CI: 0%\u201311%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.025). Despite ethnic variability in frequency, BIM deletion was not significantly associated with imatinib resistance (OR 1.43, 95% CI 0.65\u20133.15,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.37).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although BIM deletion has a significantly higher prevalence in East Asian populations, pooled evidence does not support a statistically significant association with imatinib resistance. However, large, prospective, multi\u2010ethnic studies incorporating standardized response criteria and integrated molecular profiling will be essential to clarify whether BIM genotyping holds additive value in the risk stratification for TKI resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The authors have confirmed clinical trial registration is not applicable for this submission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jha2.70372","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T12:46:14Z","timestamp":1786365974000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Meta\u2010Analysis of Imatinib Resistance in Chronic Myeloid Leukemia due to BIM Gene Deletion and Single Nucleotide Polymorphisms Reveals Ethnic Variations in Prevalence"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2232-4124","authenticated-orcid":false,"given":"Abhinav","family":"Bhattarai","sequence":"first","affiliation":[{"name":"Irell &amp; Manella Graduate School of Biological Sciences Beckman Research Institute City of Hope  Duarte California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitri","family":"Kountouris","sequence":"additional","affiliation":[{"name":"Irell &amp; Manella Graduate School of Biological Sciences Beckman Research Institute City of Hope  Duarte California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjit","family":"Sah","sequence":"additional","affiliation":[{"name":"SR Sanjeevani Hospital  Kalyanpur Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachana","family":"Mehta","sequence":"additional","affiliation":[{"name":"SR Sanjeevani Hospital  Kalyanpur Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjit","family":"Sah","sequence":"additional","affiliation":[{"name":"BMC Health System  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"R. E.EdenandJ. M.Coviello \u201cChronic Myelogenous Leukemia \u201dStatPearls updated January 16 2023 https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK531459."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-003-0810-2"},{"issue":"9","key":"e_1_2_12_4_1","first-page":"4477","article-title":"Imatinib Mesylate Versus Allogeneic Hematopoietic Stem Cell Transplantation for Patients with Chronic Myelogenous Leukemia","volume":"17","author":"Zhang G. F.","year":"2016","journal-title":"Asian Pacific Journal of Cancer Prevention"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-08-3097"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2004.12.016"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V122.21.5518.5518"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2040620712468289"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-024-02418-0"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.985363"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","unstructured":"Intrinsic TKI Resistance Is Associated With a BIM Polymorphism. 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