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.

Castagnetti, F., Gugliotta, G., Breccia, M., Stagno, F., Iurlo, A., Albano, F., et al. (2015). Long-term outcome of chronic myeloid leukemia patients treated frontline with imatinib. LEUKEMIA, 29(9), 1823-1831 [10.1038/leu.2015.152].

Long-term outcome of chronic myeloid leukemia patients treated frontline with imatinib

CASTAGNETTI, FAUSTO;GUGLIOTTA, GABRIELE;SOVERINI, SIMONA;TESTONI, NICOLETTA;CAVO, MICHELE;MARTINELLI, GIOVANNI;ROSTI, GIANANTONIO;BACCARANI, MICHELE;Palandri F. ]
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.
2015
Castagnetti, F., Gugliotta, G., Breccia, M., Stagno, F., Iurlo, A., Albano, F., et al. (2015). Long-term outcome of chronic myeloid leukemia patients treated frontline with imatinib. LEUKEMIA, 29(9), 1823-1831 [10.1038/leu.2015.152].
Castagnetti, F; Gugliotta, G.; Breccia, M.; Stagno, F.; Iurlo, A.; Albano, F.; Abruzzese, E.; Martino, B.; Levato, L.; Intermesoli, T.; Pregno, P.; Ro...espandi
File in questo prodotto:
Eventuali allegati, non sono esposti

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/529083
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 34
  • Scopus 79
  • ???jsp.display-item.citation.isi??? 70
social impact