Document Detail


Very long-term follow-up results of imatinib mesylate therapy in chronic phase chronic myeloid leukemia after failure of interferon alpha therapy.
MedLine Citation:
PMID:  22370904     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The long-term outcome of patients with chronic phase chronic myeloid leukemia treated with imatinib after failure of interferon alpha therapy has not been detailed.
METHODS: In total, 368 patients were analyzed. Univariate and multivariate survival analyses were conducted using standard statistical methods.
RESULTS: Overall, 247 patients (67%) achieved a complete cytogenetic response (CCyR). Of the 327 patients who were studied, 207 patients (63%) achieved a major molecular response (MMR), and 99 patients (30%) had undetectable breakpoint cluster region/c-abl oncogene (BCR-ABL) levels at some time during therapy. The estimated 10-year survival rate was 68%, the progression-free survival rate was 67%, and the event-free survival rate was 51%. In multivariate analysis, age ≥ 60 years, hemoglobin <10 g/dL, bone marrow basophils ≥ 5%, any peripheral blasts, and clonal evolution were independent adverse factors for survival. The estimated 7-year survival rate according to the presence of no factors (n = 154), 1 or 2 factors (n = 190), or ≥ 3 factors (n = 24) were 93%, 70%, and 25%, respectively (P < .01). Achieving an MMR, a CCyR, or a partial cytogenetic response at 12 months was associated with significantly better 10-year survival rate in a landmark analysis (10-year survival rate, 80%-90%) compared with achieving a minor cytogenetic response or a complete hematologic response (10-year survival rate, 55%-65%) or another response (10-year survival rate, 10%). In a landmark analysis that included imatinib response at 12 months, achieving a major cytogenetic response or better (hazard ratio, 0.12; P < .001) and achieving a complete hematologic response or a minor cytogenetic response (hazard ratio, 0.36; P = .003) were significant favorable prognostic factors.
CONCLUSIONS: The current results indicated that the estimated 10-year survival rate of 68% for patients with chronic myeloid leukemia who receive imatinib after failure on interferon has improved.
Authors:
Hagop Kantarjian; Susan O'Brien; Guillermo Garcia-Manero; Stefan Faderl; Farhad Ravandi; Elias Jabbour; Jianqin Shan; Jorge Cortes
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-02-27
Journal Detail:
Title:  Cancer     Volume:  118     ISSN:  1097-0142     ISO Abbreviation:  Cancer     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-07     Completed Date:  2012-08-15     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3116-22     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 American Cancer Society.
Affiliation:
Leukemia Department, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. hkantarj@mdanderson.org
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MeSH Terms
Descriptor/Qualifier:
Female
Follow-Up Studies
Fusion Proteins, bcr-abl / drug effects,  genetics
Humans
Interferon-alpha / therapeutic use*
Leukemia, Myeloid, Chronic-Phase / drug therapy*,  mortality
Male
Middle Aged
Piperazines / administration & dosage*
Prognosis
Protein Kinase Inhibitors / therapeutic use*
Pyrimidines / administration & dosage*
Retreatment
Survival Rate
Treatment Failure
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P01 CA049639/CA/NCI NIH HHS; UL1 RR024148/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Fusion Proteins, bcr-abl; 0/Interferon-alpha; 0/Piperazines; 0/Protein Kinase Inhibitors; 0/Pyrimidines; BKJ8M8G5HI/imatinib

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