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Younger patients with chronic myeloid leukemia do well in spite of poor prognostic indicators: results from the randomized CML study IV.
- Source :
-
Annals of hematology [Ann Hematol] 2014 Jan; Vol. 93 (1), pp. 71-80. Date of Electronic Publication: 2013 Oct 27. - Publication Year :
- 2014
-
Abstract
- Since the advent of tyrosine kinase inhibitors, the impact of age on outcome of chronic myeloid leukemia (CML) patients has changed. We therefore analyzed patients from the randomized CML study IV to investigate disease manifestations and outcome in different age groups. One thousand five hundred twenty-four patients with BCR-ABL-positive chronic phase CML were divided into four age groups: (1) 16-29 years, n = 120; (2) 30-44 years, n = 383; (3) 45-59 years, n = 495; and (4) ≥60 years, n = 526. Group 1 (adolescents and young adults (AYAs)) presented with more aggressive disease features (larger spleen size, more frequent symptoms of organomegaly, higher white blood count, higher percentage of peripheral blasts and lower hemoglobin levels) than the other age groups. In addition, a higher rate of patients with BCR-ABL transcript levels >10 % on the international scale (IS) at 3 months was observed. After a median observation time of 67.5 months, no inferior survival and no differences in cytogenetic and molecular remissions or progression rates were observed. We conclude that AYAs show more aggressive features and poor prognostic indicators possibly indicating differences in disease biology. This, however, does not affect outcome.
- Subjects :
- Adolescent
Adult
Age Factors
Aged
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Benzamides administration & dosage
Benzamides therapeutic use
Cytarabine administration & dosage
Female
Follow-Up Studies
Fusion Proteins, bcr-abl blood
Fusion Proteins, bcr-abl genetics
Humans
Imatinib Mesylate
Interferon-alpha administration & dosage
Kaplan-Meier Estimate
Karnofsky Performance Status
Leukemia, Myeloid, Chronic-Phase blood
Leukemia, Myeloid, Chronic-Phase drug therapy
Leukemia, Myeloid, Chronic-Phase genetics
Male
Middle Aged
Piperazines administration & dosage
Piperazines therapeutic use
Protein Kinase Inhibitors administration & dosage
Protein Kinase Inhibitors therapeutic use
Pyrimidines administration & dosage
Pyrimidines therapeutic use
RNA, Messenger blood
RNA, Neoplasm blood
Randomized Controlled Trials as Topic statistics & numerical data
Risk Factors
Splenomegaly etiology
Treatment Outcome
Young Adult
Leukemia, Myeloid, Chronic-Phase mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0584
- Volume :
- 93
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 24162333
- Full Text :
- https://doi.org/10.1007/s00277-013-1937-4