Outcome of very elderly chronic myeloid leukaemia patients treated with imatinib frontline

M. Crugnola, F. Castagnetti, M. Breccia, D. Ferrero, M.M. Trawinska, E. Abruzzese, M. Annunziata, F. Stagno, M. Tiribelli, G. Binotto, M. Bonifacio, C. Fava, A. Iurlo, C. Bucelli, G. Mansueto, A. Gozzini, F. Falzetti, E. Montefusco, E. Crisà, G. GugliottaS. Russo, M. Cedrone, A. RussoRossi, P. Pregno, A. Isidori, E. Mauro, R. Atelda, G. Giglio, F. Celesti, F. Sorà, S. Storti, A. D’Addosio, S. Galimberti, E. Orlandi, E. Calistri, M. Bocchia, F. Cavazzini, G. Rege Cambrin, N. Orofino, L. Luciano, N. Sgherza, G. Rosti, R. Latagliata, I. Capodanno

Research output: Contribution to journalArticle

Abstract

Very elderly (> 75 years) chronic myeloid leukaemia (CML) patients at diagnosis are sometimes treated with different doses of imatinib (IM) based on concomitant diseases and physicians’ judgement. However, data on long-term follow-up of these patients are still lacking. To investigate treatment response and outcome, we retrospectively revised an Italian database of 263 very elderly CML patients receiving IM from the time of diagnosis. Median age at diagnosis was 78.5 years and 56% of patients had 2 or 3 comorbidities. A complete haematological and cytogenetic response were achieved in 244 (92.8%) and 184 (69.9%) patients, respectively. In 148 cases (56.2%), a major molecular response was observed, which was deep in 63 cases (24%). A blastic phase occurred in 11 patients (4.2%). After a median follow-up of 45.0 months, 93 patients have died (9 from disease progression) and 104 (39.5%) are still in treatment with IM. Incidence of grades 3–4 haematological and non-haematological toxicity was similar to those reported in younger patients. Five-year event-free survival was 54.5% and 45.2% in patients ≤ 80 years and > 80 years, respectively (p = 0.098). Five years OS was 75.7% and 61.6% in patients ≤80 years and > 80 years, respectively (p = 0.003). These findings show that IM plays an important role in frontline treatment of very elderly CML patients without increased toxicity and any effort to treat these patients with standard doses should be made in order to achieve responses as in younger subjects. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
Original languageEnglish
JournalAnnals of Hematology
DOIs
Publication statusPublished - 2019

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Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Imatinib Mesylate
Cytogenetics
Disease-Free Survival
Germany
Disease Progression
Comorbidity
Databases
Physicians

Keywords

  • Chronic myeloid leukaemia
  • Elderly
  • Outcome
  • Tyrosine kinase inhibitor

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Outcome of very elderly chronic myeloid leukaemia patients treated with imatinib frontline. / Crugnola, M.; Castagnetti, F.; Breccia, M.; Ferrero, D.; Trawinska, M.M.; Abruzzese, E.; Annunziata, M.; Stagno, F.; Tiribelli, M.; Binotto, G.; Bonifacio, M.; Fava, C.; Iurlo, A.; Bucelli, C.; Mansueto, G.; Gozzini, A.; Falzetti, F.; Montefusco, E.; Crisà, E.; Gugliotta, G.; Russo, S.; Cedrone, M.; RussoRossi, A.; Pregno, P.; Isidori, A.; Mauro, E.; Atelda, R.; Giglio, G.; Celesti, F.; Sorà, F.; Storti, S.; D’Addosio, A.; Galimberti, S.; Orlandi, E.; Calistri, E.; Bocchia, M.; Cavazzini, F.; Rege Cambrin, G.; Orofino, N.; Luciano, L.; Sgherza, N.; Rosti, G.; Latagliata, R.; Capodanno, I.

In: Annals of Hematology, 2019.

Research output: Contribution to journalArticle

Crugnola, M, Castagnetti, F, Breccia, M, Ferrero, D, Trawinska, MM, Abruzzese, E, Annunziata, M, Stagno, F, Tiribelli, M, Binotto, G, Bonifacio, M, Fava, C, Iurlo, A, Bucelli, C, Mansueto, G, Gozzini, A, Falzetti, F, Montefusco, E, Crisà, E, Gugliotta, G, Russo, S, Cedrone, M, RussoRossi, A, Pregno, P, Isidori, A, Mauro, E, Atelda, R, Giglio, G, Celesti, F, Sorà, F, Storti, S, D’Addosio, A, Galimberti, S, Orlandi, E, Calistri, E, Bocchia, M, Cavazzini, F, Rege Cambrin, G, Orofino, N, Luciano, L, Sgherza, N, Rosti, G, Latagliata, R & Capodanno, I 2019, 'Outcome of very elderly chronic myeloid leukaemia patients treated with imatinib frontline', Annals of Hematology. https://doi.org/10.1007/s00277-019-03767-y
Crugnola, M. ; Castagnetti, F. ; Breccia, M. ; Ferrero, D. ; Trawinska, M.M. ; Abruzzese, E. ; Annunziata, M. ; Stagno, F. ; Tiribelli, M. ; Binotto, G. ; Bonifacio, M. ; Fava, C. ; Iurlo, A. ; Bucelli, C. ; Mansueto, G. ; Gozzini, A. ; Falzetti, F. ; Montefusco, E. ; Crisà, E. ; Gugliotta, G. ; Russo, S. ; Cedrone, M. ; RussoRossi, A. ; Pregno, P. ; Isidori, A. ; Mauro, E. ; Atelda, R. ; Giglio, G. ; Celesti, F. ; Sorà, F. ; Storti, S. ; D’Addosio, A. ; Galimberti, S. ; Orlandi, E. ; Calistri, E. ; Bocchia, M. ; Cavazzini, F. ; Rege Cambrin, G. ; Orofino, N. ; Luciano, L. ; Sgherza, N. ; Rosti, G. ; Latagliata, R. ; Capodanno, I. / Outcome of very elderly chronic myeloid leukaemia patients treated with imatinib frontline. In: Annals of Hematology. 2019.
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abstract = "Very elderly (> 75 years) chronic myeloid leukaemia (CML) patients at diagnosis are sometimes treated with different doses of imatinib (IM) based on concomitant diseases and physicians’ judgement. However, data on long-term follow-up of these patients are still lacking. To investigate treatment response and outcome, we retrospectively revised an Italian database of 263 very elderly CML patients receiving IM from the time of diagnosis. Median age at diagnosis was 78.5 years and 56{\%} of patients had 2 or 3 comorbidities. A complete haematological and cytogenetic response were achieved in 244 (92.8{\%}) and 184 (69.9{\%}) patients, respectively. In 148 cases (56.2{\%}), a major molecular response was observed, which was deep in 63 cases (24{\%}). A blastic phase occurred in 11 patients (4.2{\%}). After a median follow-up of 45.0 months, 93 patients have died (9 from disease progression) and 104 (39.5{\%}) are still in treatment with IM. Incidence of grades 3–4 haematological and non-haematological toxicity was similar to those reported in younger patients. Five-year event-free survival was 54.5{\%} and 45.2{\%} in patients ≤ 80 years and > 80 years, respectively (p = 0.098). Five years OS was 75.7{\%} and 61.6{\%} in patients ≤80 years and > 80 years, respectively (p = 0.003). These findings show that IM plays an important role in frontline treatment of very elderly CML patients without increased toxicity and any effort to treat these patients with standard doses should be made in order to achieve responses as in younger subjects. {\circledC} 2019, Springer-Verlag GmbH Germany, part of Springer Nature.",
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T1 - Outcome of very elderly chronic myeloid leukaemia patients treated with imatinib frontline

AU - Crugnola, M.

AU - Castagnetti, F.

AU - Breccia, M.

AU - Ferrero, D.

AU - Trawinska, M.M.

AU - Abruzzese, E.

AU - Annunziata, M.

AU - Stagno, F.

AU - Tiribelli, M.

AU - Binotto, G.

AU - Bonifacio, M.

AU - Fava, C.

AU - Iurlo, A.

AU - Bucelli, C.

AU - Mansueto, G.

AU - Gozzini, A.

AU - Falzetti, F.

AU - Montefusco, E.

AU - Crisà, E.

AU - Gugliotta, G.

AU - Russo, S.

AU - Cedrone, M.

AU - RussoRossi, A.

AU - Pregno, P.

AU - Isidori, A.

AU - Mauro, E.

AU - Atelda, R.

AU - Giglio, G.

AU - Celesti, F.

AU - Sorà, F.

AU - Storti, S.

AU - D’Addosio, A.

AU - Galimberti, S.

AU - Orlandi, E.

AU - Calistri, E.

AU - Bocchia, M.

AU - Cavazzini, F.

AU - Rege Cambrin, G.

AU - Orofino, N.

AU - Luciano, L.

AU - Sgherza, N.

AU - Rosti, G.

AU - Latagliata, R.

AU - Capodanno, I.

N1 - Export Date: 19 August 2019 CODEN: ANHEE Correspondence Address: Crugnola, M.; Hematology and BMT Center, “Azienda Ospedaliero-Universitaria di Parma,” Department Medicine and Surgery, University of ParmaItaly; email: mcrugnola@ao.pr.it

PY - 2019

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N2 - Very elderly (> 75 years) chronic myeloid leukaemia (CML) patients at diagnosis are sometimes treated with different doses of imatinib (IM) based on concomitant diseases and physicians’ judgement. However, data on long-term follow-up of these patients are still lacking. To investigate treatment response and outcome, we retrospectively revised an Italian database of 263 very elderly CML patients receiving IM from the time of diagnosis. Median age at diagnosis was 78.5 years and 56% of patients had 2 or 3 comorbidities. A complete haematological and cytogenetic response were achieved in 244 (92.8%) and 184 (69.9%) patients, respectively. In 148 cases (56.2%), a major molecular response was observed, which was deep in 63 cases (24%). A blastic phase occurred in 11 patients (4.2%). After a median follow-up of 45.0 months, 93 patients have died (9 from disease progression) and 104 (39.5%) are still in treatment with IM. Incidence of grades 3–4 haematological and non-haematological toxicity was similar to those reported in younger patients. Five-year event-free survival was 54.5% and 45.2% in patients ≤ 80 years and > 80 years, respectively (p = 0.098). Five years OS was 75.7% and 61.6% in patients ≤80 years and > 80 years, respectively (p = 0.003). These findings show that IM plays an important role in frontline treatment of very elderly CML patients without increased toxicity and any effort to treat these patients with standard doses should be made in order to achieve responses as in younger subjects. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

AB - Very elderly (> 75 years) chronic myeloid leukaemia (CML) patients at diagnosis are sometimes treated with different doses of imatinib (IM) based on concomitant diseases and physicians’ judgement. However, data on long-term follow-up of these patients are still lacking. To investigate treatment response and outcome, we retrospectively revised an Italian database of 263 very elderly CML patients receiving IM from the time of diagnosis. Median age at diagnosis was 78.5 years and 56% of patients had 2 or 3 comorbidities. A complete haematological and cytogenetic response were achieved in 244 (92.8%) and 184 (69.9%) patients, respectively. In 148 cases (56.2%), a major molecular response was observed, which was deep in 63 cases (24%). A blastic phase occurred in 11 patients (4.2%). After a median follow-up of 45.0 months, 93 patients have died (9 from disease progression) and 104 (39.5%) are still in treatment with IM. Incidence of grades 3–4 haematological and non-haematological toxicity was similar to those reported in younger patients. Five-year event-free survival was 54.5% and 45.2% in patients ≤ 80 years and > 80 years, respectively (p = 0.098). Five years OS was 75.7% and 61.6% in patients ≤80 years and > 80 years, respectively (p = 0.003). These findings show that IM plays an important role in frontline treatment of very elderly CML patients without increased toxicity and any effort to treat these patients with standard doses should be made in order to achieve responses as in younger subjects. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.

KW - Chronic myeloid leukaemia

KW - Elderly

KW - Outcome

KW - Tyrosine kinase inhibitor

U2 - 10.1007/s00277-019-03767-y

DO - 10.1007/s00277-019-03767-y

M3 - Article

JO - Annals of Hematology

JF - Annals of Hematology

SN - 0939-5555

ER -