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.
| Original language | English |
|---|---|
| Pages (from-to) | 2329-2338 |
| Number of pages | 10 |
| Journal | Annals of Hematology |
| Volume | 98 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 2019 |
Fingerprint
Keywords
- Aged
- Aged, 80 and over
- Disease-Free Survival
- Female
- Follow-Up Studies
- Humans
- Imatinib Mesylate/administration & dosage
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Male
- Survival Rate
- Time Factors
Cite this
Outcome of very elderly chronic myeloid leukaemia patients treated with imatinib frontline. / Crugnola, Monica; Castagnetti, Fausto; Breccia, Massimo; Ferrero, Dario; Trawinska, Malgorzata Monika; Abruzzese, Elisabetta; Annunziata, Mario; Stagno, Fabio; Tiribelli, Mario; Binotto, Gianni; Bonifacio, Massimiliano; Fava, Carmen; Iurlo, Alessandra; Bucelli, Cristina; Mansueto, Giovanna; Gozzini, Antonella; Falzetti, Franca; Montefusco, Enrico; Crisà, Elena; Gugliotta, Gabriele; Russo, Sabina; Cedrone, Michele; RussoRossi, Antonella; Pregno, Patrizia; Isidori, Alessandro; Mauro, Endri; Atelda, Romano; Giglio, Gianfranco; Celesti, Francesca; Sorà, Federica; Storti, Sergio; D'Addosio, Adam; Galimberti, Sara; Orlandi, Ester; Calistri, Elisabetta; Bocchia, Monica; Cavazzini, Francesco; Rege Cambrin, Giovanna; Orofino, Nicola; Luciano, Luigiana; Sgherza, Nicola; Rosti, Gianantonio; Latagliata, Roberto; Capodanno, Isabella.
In: Annals of Hematology, Vol. 98, No. 10, 10.2019, p. 2329-2338.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Outcome of very elderly chronic myeloid leukaemia patients treated with imatinib frontline
AU - Crugnola, Monica
AU - Castagnetti, Fausto
AU - Breccia, Massimo
AU - Ferrero, Dario
AU - Trawinska, Malgorzata Monika
AU - Abruzzese, Elisabetta
AU - Annunziata, Mario
AU - Stagno, Fabio
AU - Tiribelli, Mario
AU - Binotto, Gianni
AU - Bonifacio, Massimiliano
AU - Fava, Carmen
AU - Iurlo, Alessandra
AU - Bucelli, Cristina
AU - Mansueto, Giovanna
AU - Gozzini, Antonella
AU - Falzetti, Franca
AU - Montefusco, Enrico
AU - Crisà, Elena
AU - Gugliotta, Gabriele
AU - Russo, Sabina
AU - Cedrone, Michele
AU - RussoRossi, Antonella
AU - Pregno, Patrizia
AU - Isidori, Alessandro
AU - Mauro, Endri
AU - Atelda, Romano
AU - Giglio, Gianfranco
AU - Celesti, Francesca
AU - Sorà, Federica
AU - Storti, Sergio
AU - D'Addosio, Adam
AU - Galimberti, Sara
AU - Orlandi, Ester
AU - Calistri, Elisabetta
AU - Bocchia, Monica
AU - Cavazzini, Francesco
AU - Rege Cambrin, Giovanna
AU - Orofino, Nicola
AU - Luciano, Luigiana
AU - Sgherza, Nicola
AU - Rosti, Gianantonio
AU - Latagliata, Roberto
AU - Capodanno, Isabella
PY - 2019/10
Y1 - 2019/10
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.
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.
KW - Aged
KW - Aged, 80 and over
KW - Disease-Free Survival
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Imatinib Mesylate/administration & dosage
KW - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
KW - Male
KW - Survival Rate
KW - Time Factors
U2 - 10.1007/s00277-019-03767-y
DO - 10.1007/s00277-019-03767-y
M3 - Article
C2 - 31392461
VL - 98
SP - 2329
EP - 2338
JO - Annals of Hematology
JF - Annals of Hematology
SN - 0939-5555
IS - 10
ER -