A population-based study of chronic myeloid leukemia patients treated with imatinib in first line

Fausto Castagnetti, Francesco Di Raimondo, Antonio De Vivo, Antonio Spitaleri, Gabriele Gugliotta, Francesco Fabbiano, Isabella Capodanno, Donato Mannina, Marzia Salvucci, Agostino Antolino, Roberto Marasca, Maurizio Musso, Monica Crugnola, Stefana Impera, Elena E. Trabacchi, Caterina Musolino, Francesco Cavazzini, Giuseppe Mineo, Patrizia Tosi, Carmela TomaselliMichele Rizzo, Sergio Siragusa, Miriam Fogli, Riccardo Ragionieri, Alessandro Zironi, Simona Soverini, Giovanni Martinelli, Michele Cavo, Paolo Vigneri, Fabio Stagno, Gianantonio Rosti, Michele Baccarani

Research output: Contribution to journalArticle

Abstract

Chronic myeloid leukemia (CML) treatment is based on company-sponsored and academic trials testing different tyrosine kinase inhibitors (TKIs) as first-line therapy. These studies included patients selected according to many inclusion–exclusion criteria, particularly age and comorbidities, with specific treatment obligations. In daily clinical practice (real-life), inclusion–exclusion criteria do not exist, and the treatment outcome does not only depend on the choice of first-line TKI but also on second- and third-line TKIs. To investigate in a real-life setting the response and the outcome on first-line imatinib, with switch to second generation TKIs in case of unsatisfying response or intolerance, we analyzed all newly diagnosed patients (N = 236), living in two Italian regions, registered in a prospective study according to population-based criteria and treated front-line with imatinib. A switch from imatinib to second-generation TKIs was reported in 14% of patients for side effects and in 24% for failure or suboptimal response, with an improvement of molecular response in 57% of them. The 5-year overall survival (OS) and leukemia-related survival (LRS) were 85% and 93%, respectively; the 4-year rates of MR3.0 and MR4.0 were 75% and 48%, respectively. Cardiovascular complications were reported in 4% of patients treated with imatinib alone and in 6% of patients receiving nilotinib as second-line. Older age (≥70 years) affected OS, but not LRS. These data provide an unbiased reference on the CML management and on the results of TKI treatment in real-life, according to ELN recommendations, using imatinib as first-line treatment and second-generation TKIs as second-line therapy. Am. J. Hematol. 92:82–87, 2017.

Original languageEnglish
Pages (from-to)82-87
Number of pages6
JournalAmerican Journal of Hematology
Volume92
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

Fingerprint

Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Protein-Tyrosine Kinases
Population
Survival
Leukemia
Therapeutics
Imatinib Mesylate
Comorbidity
Prospective Studies

ASJC Scopus subject areas

  • Hematology

Cite this

Castagnetti, F., Di Raimondo, F., Vivo, A. D., Spitaleri, A., Gugliotta, G., Fabbiano, F., ... Baccarani, M. (2017). A population-based study of chronic myeloid leukemia patients treated with imatinib in first line. American Journal of Hematology, 92(1), 82-87. https://doi.org/10.1002/ajh.24591

A population-based study of chronic myeloid leukemia patients treated with imatinib in first line. / Castagnetti, Fausto; Di Raimondo, Francesco; Vivo, Antonio De; Spitaleri, Antonio; Gugliotta, Gabriele; Fabbiano, Francesco; Capodanno, Isabella; Mannina, Donato; Salvucci, Marzia; Antolino, Agostino; Marasca, Roberto; Musso, Maurizio; Crugnola, Monica; Impera, Stefana; Trabacchi, Elena E.; Musolino, Caterina; Cavazzini, Francesco; Mineo, Giuseppe; Tosi, Patrizia; Tomaselli, Carmela; Rizzo, Michele; Siragusa, Sergio; Fogli, Miriam; Ragionieri, Riccardo; Zironi, Alessandro; Soverini, Simona; Martinelli, Giovanni; Cavo, Michele; Vigneri, Paolo; Stagno, Fabio; Rosti, Gianantonio; Baccarani, Michele.

In: American Journal of Hematology, Vol. 92, No. 1, 01.01.2017, p. 82-87.

Research output: Contribution to journalArticle

Castagnetti, F, Di Raimondo, F, Vivo, AD, Spitaleri, A, Gugliotta, G, Fabbiano, F, Capodanno, I, Mannina, D, Salvucci, M, Antolino, A, Marasca, R, Musso, M, Crugnola, M, Impera, S, Trabacchi, EE, Musolino, C, Cavazzini, F, Mineo, G, Tosi, P, Tomaselli, C, Rizzo, M, Siragusa, S, Fogli, M, Ragionieri, R, Zironi, A, Soverini, S, Martinelli, G, Cavo, M, Vigneri, P, Stagno, F, Rosti, G & Baccarani, M 2017, 'A population-based study of chronic myeloid leukemia patients treated with imatinib in first line', American Journal of Hematology, vol. 92, no. 1, pp. 82-87. https://doi.org/10.1002/ajh.24591
Castagnetti F, Di Raimondo F, Vivo AD, Spitaleri A, Gugliotta G, Fabbiano F et al. A population-based study of chronic myeloid leukemia patients treated with imatinib in first line. American Journal of Hematology. 2017 Jan 1;92(1):82-87. https://doi.org/10.1002/ajh.24591
Castagnetti, Fausto ; Di Raimondo, Francesco ; Vivo, Antonio De ; Spitaleri, Antonio ; Gugliotta, Gabriele ; Fabbiano, Francesco ; Capodanno, Isabella ; Mannina, Donato ; Salvucci, Marzia ; Antolino, Agostino ; Marasca, Roberto ; Musso, Maurizio ; Crugnola, Monica ; Impera, Stefana ; Trabacchi, Elena E. ; Musolino, Caterina ; Cavazzini, Francesco ; Mineo, Giuseppe ; Tosi, Patrizia ; Tomaselli, Carmela ; Rizzo, Michele ; Siragusa, Sergio ; Fogli, Miriam ; Ragionieri, Riccardo ; Zironi, Alessandro ; Soverini, Simona ; Martinelli, Giovanni ; Cavo, Michele ; Vigneri, Paolo ; Stagno, Fabio ; Rosti, Gianantonio ; Baccarani, Michele. / A population-based study of chronic myeloid leukemia patients treated with imatinib in first line. In: American Journal of Hematology. 2017 ; Vol. 92, No. 1. pp. 82-87.
@article{ddfe6a3824d64ca7bf1199f5cb6aac99,
title = "A population-based study of chronic myeloid leukemia patients treated with imatinib in first line",
abstract = "Chronic myeloid leukemia (CML) treatment is based on company-sponsored and academic trials testing different tyrosine kinase inhibitors (TKIs) as first-line therapy. These studies included patients selected according to many inclusion–exclusion criteria, particularly age and comorbidities, with specific treatment obligations. In daily clinical practice (real-life), inclusion–exclusion criteria do not exist, and the treatment outcome does not only depend on the choice of first-line TKI but also on second- and third-line TKIs. To investigate in a real-life setting the response and the outcome on first-line imatinib, with switch to second generation TKIs in case of unsatisfying response or intolerance, we analyzed all newly diagnosed patients (N = 236), living in two Italian regions, registered in a prospective study according to population-based criteria and treated front-line with imatinib. A switch from imatinib to second-generation TKIs was reported in 14{\%} of patients for side effects and in 24{\%} for failure or suboptimal response, with an improvement of molecular response in 57{\%} of them. The 5-year overall survival (OS) and leukemia-related survival (LRS) were 85{\%} and 93{\%}, respectively; the 4-year rates of MR3.0 and MR4.0 were 75{\%} and 48{\%}, respectively. Cardiovascular complications were reported in 4{\%} of patients treated with imatinib alone and in 6{\%} of patients receiving nilotinib as second-line. Older age (≥70 years) affected OS, but not LRS. These data provide an unbiased reference on the CML management and on the results of TKI treatment in real-life, according to ELN recommendations, using imatinib as first-line treatment and second-generation TKIs as second-line therapy. Am. J. Hematol. 92:82–87, 2017.",
author = "Fausto Castagnetti and {Di Raimondo}, Francesco and Vivo, {Antonio De} and Antonio Spitaleri and Gabriele Gugliotta and Francesco Fabbiano and Isabella Capodanno and Donato Mannina and Marzia Salvucci and Agostino Antolino and Roberto Marasca and Maurizio Musso and Monica Crugnola and Stefana Impera and Trabacchi, {Elena E.} and Caterina Musolino and Francesco Cavazzini and Giuseppe Mineo and Patrizia Tosi and Carmela Tomaselli and Michele Rizzo and Sergio Siragusa and Miriam Fogli and Riccardo Ragionieri and Alessandro Zironi and Simona Soverini and Giovanni Martinelli and Michele Cavo and Paolo Vigneri and Fabio Stagno and Gianantonio Rosti and Michele Baccarani",
year = "2017",
month = "1",
day = "1",
doi = "10.1002/ajh.24591",
language = "English",
volume = "92",
pages = "82--87",
journal = "American Journal of Hematology",
issn = "0361-8609",
publisher = "Wiley-Liss Inc.",
number = "1",

}

TY - JOUR

T1 - A population-based study of chronic myeloid leukemia patients treated with imatinib in first line

AU - Castagnetti, Fausto

AU - Di Raimondo, Francesco

AU - Vivo, Antonio De

AU - Spitaleri, Antonio

AU - Gugliotta, Gabriele

AU - Fabbiano, Francesco

AU - Capodanno, Isabella

AU - Mannina, Donato

AU - Salvucci, Marzia

AU - Antolino, Agostino

AU - Marasca, Roberto

AU - Musso, Maurizio

AU - Crugnola, Monica

AU - Impera, Stefana

AU - Trabacchi, Elena E.

AU - Musolino, Caterina

AU - Cavazzini, Francesco

AU - Mineo, Giuseppe

AU - Tosi, Patrizia

AU - Tomaselli, Carmela

AU - Rizzo, Michele

AU - Siragusa, Sergio

AU - Fogli, Miriam

AU - Ragionieri, Riccardo

AU - Zironi, Alessandro

AU - Soverini, Simona

AU - Martinelli, Giovanni

AU - Cavo, Michele

AU - Vigneri, Paolo

AU - Stagno, Fabio

AU - Rosti, Gianantonio

AU - Baccarani, Michele

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Chronic myeloid leukemia (CML) treatment is based on company-sponsored and academic trials testing different tyrosine kinase inhibitors (TKIs) as first-line therapy. These studies included patients selected according to many inclusion–exclusion criteria, particularly age and comorbidities, with specific treatment obligations. In daily clinical practice (real-life), inclusion–exclusion criteria do not exist, and the treatment outcome does not only depend on the choice of first-line TKI but also on second- and third-line TKIs. To investigate in a real-life setting the response and the outcome on first-line imatinib, with switch to second generation TKIs in case of unsatisfying response or intolerance, we analyzed all newly diagnosed patients (N = 236), living in two Italian regions, registered in a prospective study according to population-based criteria and treated front-line with imatinib. A switch from imatinib to second-generation TKIs was reported in 14% of patients for side effects and in 24% for failure or suboptimal response, with an improvement of molecular response in 57% of them. The 5-year overall survival (OS) and leukemia-related survival (LRS) were 85% and 93%, respectively; the 4-year rates of MR3.0 and MR4.0 were 75% and 48%, respectively. Cardiovascular complications were reported in 4% of patients treated with imatinib alone and in 6% of patients receiving nilotinib as second-line. Older age (≥70 years) affected OS, but not LRS. These data provide an unbiased reference on the CML management and on the results of TKI treatment in real-life, according to ELN recommendations, using imatinib as first-line treatment and second-generation TKIs as second-line therapy. Am. J. Hematol. 92:82–87, 2017.

AB - Chronic myeloid leukemia (CML) treatment is based on company-sponsored and academic trials testing different tyrosine kinase inhibitors (TKIs) as first-line therapy. These studies included patients selected according to many inclusion–exclusion criteria, particularly age and comorbidities, with specific treatment obligations. In daily clinical practice (real-life), inclusion–exclusion criteria do not exist, and the treatment outcome does not only depend on the choice of first-line TKI but also on second- and third-line TKIs. To investigate in a real-life setting the response and the outcome on first-line imatinib, with switch to second generation TKIs in case of unsatisfying response or intolerance, we analyzed all newly diagnosed patients (N = 236), living in two Italian regions, registered in a prospective study according to population-based criteria and treated front-line with imatinib. A switch from imatinib to second-generation TKIs was reported in 14% of patients for side effects and in 24% for failure or suboptimal response, with an improvement of molecular response in 57% of them. The 5-year overall survival (OS) and leukemia-related survival (LRS) were 85% and 93%, respectively; the 4-year rates of MR3.0 and MR4.0 were 75% and 48%, respectively. Cardiovascular complications were reported in 4% of patients treated with imatinib alone and in 6% of patients receiving nilotinib as second-line. Older age (≥70 years) affected OS, but not LRS. These data provide an unbiased reference on the CML management and on the results of TKI treatment in real-life, according to ELN recommendations, using imatinib as first-line treatment and second-generation TKIs as second-line therapy. Am. J. Hematol. 92:82–87, 2017.

UR - http://www.scopus.com/inward/record.url?scp=85002646187&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85002646187&partnerID=8YFLogxK

U2 - 10.1002/ajh.24591

DO - 10.1002/ajh.24591

M3 - Article

AN - SCOPUS:85002646187

VL - 92

SP - 82

EP - 87

JO - American Journal of Hematology

JF - American Journal of Hematology

SN - 0361-8609

IS - 1

ER -