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Tyrosine Kinase Inhibitors as Initial Therapy for Patients with Chronic Myeloid Leukemia in Accelerated Phase
- Source :
- Clinical lymphoma, myeloma & leukemia, vol 14, iss 2
- Publication Year :
- 2013
-
Abstract
- Background Accelerated phase CML most frequently represents a progression state in CML. However, some patients present with AP features at the time of diagnosis. There is limited information on the outcome of these patients who received TKIs as initial therapy. Patients and Methods We analyzed the outcome of 51 consecutive patients with CML who presented with features of AP at the time of diagnosis, including blasts ≥ 15% (n = 6), basophils ≥ 20% (n = 22), platelets 9 /L (n = 3), cytogenetic clonal evolution (n = 17), or more than 1 feature (n = 3). Patients received initial therapy with imatinib (n = 30), dasatinib (n = 5), or nilotinib (n = 16). Results The rate of complete cytogenetic response for patients treated with imatinib was 80%, and with dasatinib or nilotinib was 90%. Major molecular response (MMR) (Breakpoint Cluster Region (BCR)-Abelson (ABL)/ABL ≤ 0.1%, International Scale [IS]) was achieved in 69% of patients including complete molecular response (BCR-ABL/ABL ≤ 0.0032% IS) in 49%. MMR rates for patients treated with imatinib were 63%, and with 2GTKIs, 76%. Overall survival at 36 months was 87% with imatinib and 95% with 2GTKIs. Conclusion TKIs should be considered standard initial therapy for patients with AP at the time of diagnosis.
- Subjects :
- Oncology
Myeloid
Male
Cancer Research
Time Factors
bcr-abl
Dasatinib
Fusion Proteins, bcr-abl
Somatic evolution in cancer
Accelerated phase CML
Major molecular response
Piperazines
hemic and lymphatic diseases
80 and over
Cancer
Aged, 80 and over
ABL
Leukemia
breakpoint cluster region
Myeloid leukemia
Hematology
Middle Aged
Protein-Tyrosine Kinases
Treatment Outcome
6.1 Pharmaceuticals
Benzamides
Imatinib Mesylate
Female
Tyrosine kinase
medicine.drug
Adult
medicine.medical_specialty
Clinical Sciences
Oncology and Carcinogenesis
Leukemia, Myeloid, Accelerated Phase
Accelerated Phase
Article
Disease-Free Survival
Young Adult
Rare Diseases
Clinical Research
Internal medicine
medicine
Humans
neoplasms
Protein Kinase Inhibitors
Aged
Complete cytogenetic response
Tyrosine kinase inhibitors
business.industry
Fusion Proteins
Evaluation of treatments and therapeutic interventions
Imatinib
Thiazoles
Second generation TKI
Orphan Drug
Pyrimidines
Nilotinib
Immunology
business
Follow-Up Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Clinical lymphoma, myeloma & leukemia, vol 14, iss 2
- Accession number :
- edsair.doi.dedup.....228af92cacc419ea1f0d7203dc730208