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

Monica Crugnola, Fausto Castagnetti, Massimo Breccia, Dario Ferrero, Malgorzata Monika Trawinska, Elisabetta Abruzzese, Mario Annunziata, Fabio Stagno, Mario Tiribelli, Gianni Binotto, Massimiliano Bonifacio, Carmen Fava, Alessandra Iurlo, Cristina Bucelli, Giovanna Mansueto, Antonella Gozzini, Franca Falzetti, Enrico Montefusco, Elena Crisà, Gabriele GugliottaSabina Russo, Michele Cedrone, Antonella RussoRossi, Patrizia Pregno, Alessandro Isidori, Endri Mauro, Romano Atelda, Gianfranco Giglio, Francesca Celesti, Federica Sorà, Sergio Storti, Adam D'Addosio, Sara Galimberti, Ester Orlandi, Elisabetta Calistri, Monica Bocchia, Francesco Cavazzini, Giovanna Rege Cambrin, Nicola Orofino, Luigiana Luciano, Nicola Sgherza, Gianantonio Rosti, Roberto Latagliata, Isabella 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.

Original languageEnglish
Pages (from-to)2329-2338
Number of pages10
JournalAnnals of Hematology
Volume98
Issue number10
DOIs
Publication statusPublished - Oct 2019

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

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