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 language | English |
|---|---|
| Pages (from-to) | 82-87 |
| Number of pages | 6 |
| Journal | American Journal of Hematology |
| Volume | 92 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 1 2017 |
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ASJC Scopus subject areas
- Hematology
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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 journal › Article
}
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 -