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Long-term outcome of chronic myeloid leukemia patients treated frontline with imatinib
- Publication Year :
- 2015
-
Abstract
- For almost 10 years imatinib has been the therapeutic standard of chronic myeloid leukemia. The introduction of other tyrosine kinase inhibitors (TKIs) raised a debate on treatment optimization. The debate is still heated: some studies have protocol restrictions or limited follow-up; in other studies, some relevant data are missing. The aim of this report is to provide a comprehensive, long-term, intention-to-treat, analysis of 559 newly diagnosed, chronic-phase, patients treated frontline with imatinib. With a minimum follow-up of 66 months, 65% of patients were still on imatinib, 19% were on alternative treatment, 12% died and 4% were lost to follow-up. The prognostic value of BCR-ABL1 ratio at 3 months (⩽10% in 81% of patients) was confirmed. The prognostic value of complete cytogenetic response and major molecular response at 1 year was confirmed. The 6-year overall survival was 89%, but as 50% of deaths occurred in remission, the 6-year cumulative incidence of leukemia-related death was 5%. The long-term outcome of first-line imatinib was excellent, also because of second-line treatment with other TKIs, but all responses and outcomes were inferior in high-risk patients, suggesting that to optimize treatment results, a specific risk-adapted treatment is needed for such patients.
- Subjects :
- DIAGNOSED CHRONIC-PHASE
Oncology
Male
Cancer Research
Time Factors
bcr-abl
Fusion Proteins, bcr-abl
Antineoplastic Agent
Hematology
Anesthesiology and Pain Medicine
hemic and lymphatic diseases
Antineoplastic Combined Chemotherapy Protocols
80 and over
Cumulative incidence
Young adult
Chronic
Aged, 80 and over
Leukemia
PATIENTS RECEIVING IMATINIB
CHRONIC MYELOGENOUS LEUKEMIA
TYROSINE KINASE INHIBITORS
BCR-ABL1 TRANSCRIPT LEVELS
EARLY MOLECULAR RESPONSE
CML WORKING PARTY
3-YEAR FOLLOW-UP
EUROPEAN LEUKEMIANET
400 MG
Myeloid leukemia
Middle Aged
Prognosis
Treatment Outcome
Retreatment
Imatinib Mesylate
Female
Tyrosine kinase
Human
medicine.drug
Adult
medicine.medical_specialty
Time Factor
Adolescent
Prognosi
Protein Kinase Inhibitor
Socio-culturale
Antineoplastic Agents
Treatment results
Follow-Up Studie
Young Adult
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Internal medicine
medicine
Humans
Protein Kinase Inhibitors
Aged
Antineoplastic Combined Chemotherapy Protocol
business.industry
Fusion Proteins
Imatinib
Follow-Up Studies
Surgery
Imatinib mesylate
BCR-ABL Positive
business
Myelogenous
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....b9a3f6a783375013273256c71341e1c8