Prolonged Survival and Carcinoma as Frequent Cause of Death in Patients Treated with Sustained Imatinib Mesylate for Advanced Chronic Phase CML Intolerant or Refractory to Interferon.

Introduction: Imatinib mesylate (IM) proved effective in patients (pts) with CML in advanced chronic phase (CP) not responsive/intolerant to recombinant alfa-interferon (IFN) and not candidate to allogeneic stem cell transplantation (SCT). The long term outcome of these pts, including blastic phase (BP) evolution and cause of death, is still partially known. Since their bcr/abl transcript levels were reduced by the prolonged use of IM, even in the absence of a karyotypic response (KR) (Cariani, Ann Hematol, 2003), we have treated them, irrespective of their karyotypic response, with sustained IM until death or evolution to blastic crisis, and have analysed their outcome in comparison with earlier pts treated at our institution with IFN when IM was not available, and with more recent pts receiving IM upfront.