TORNA ALL’ELENCO

Long-term follow-up in very elderly patients with chronic myeloid leukemia treated with imatinib frontline in Haematologica

2017
AOU San Luigi di Orbassano

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (39)Vedi tutti...

Crugnola M

Latagliata R

Breccia M


et alii...

Abstract

Background: Very elderly (>75 yrs) people are a substantial proportion of chronic myeloid leukemia (CML) patients that sometimes receive Imatinib (IM) at reduced doses based on physicians' judgment. However, data on long-term follow-up of these patients are still lacking. Aims: To investigate the treatment response and outcome in a cohort of very elderly patients with newly diagnosed CML in chronic phase. Methods:We revised in a retrospective database 263 CML patients aged ? 75 years and diagnosed from 2/2002 to 1/2016 and treated with IM frontline; among these, 121 patients (46%) were older than 80 yrs. Results: Median age at diagnosis was 78.5 yrs [interquartile range (IQR) [76.3-81.3]. Sokal Risk at diagnosis was low in 1 patient (0.4%), intermediate in 171 (68.4%), high in 78 (31.2%) and not evaluable in 13 patients. As regards comorbidities, 63 patients had no or 1 concomitant disease, 147 patients 2 or 3 and 53 patients (20.1%) 4 or more. Median interval from diagnosis to IM start was 0.8 month (IQR 0.3-1.6): the initial IM dose was 400mg/day in 180 (68.4%), 300mg/day in 67 (25.5%) and <300mg/day in 16 (6.1%) patients. According to WHO, grade 3-4 haematological and extra-haematological toxicities were reported in 57 (21,7%) and 51 (19.4%) patients, respectively. As regards cumulative response, 13 patients (4.9%) discontinued IM due to early toxicity, 4 (1.5%) were resistant and 2 (0.8%) died from unrelated causes early after IM initiation; 250 patients (92.8%) achieved a complete haematological response (CHR). Among these, 208 (79% of all 263 patients) achieved a cytogenetic response (CyR), which was partial in 18 patients and complete (CCyR) in 190 (72.2% ) after a median period of 6.1 months since IM initiation (IQR 3.4-9.1). Among the 190 patients in CCyR, 148 (56.2%) achieved a molecular response (MMolR) (ratio < 0.1) after a median period time of 13.7 months (IQR 9.0-22.3). Eleven patients (4.2%) developed a blastic phase (myeloid in 8 and lympho

Keywords

imatinib; achievement; aged; blast cell crisis; blood toxicity; clinical trial; comorbidity; controlled study; data base; diagnosis; drug therapy; event free survival; female; follow up; gender; genetic susceptibility; human; lymphatic system; major clinical study; male; multivariate analysis; overall survival; platelet count; univariate analysis; very elderly;