Evaluation of Long-Term Outcomes, Cytogenetic and Molecular Responses with Imatinib Mesylate in Early and Late Chronic-Phase Chronic Myeloid Leukemia: A Report from a Single Institute

Abstract

Here we compare the management and survival outcomes of chronic myeloid leukemia (CML) patients who had early or late imatinib mesylate (IM) therapy. The cytogenetic and molecular responses of 189 CML patients were analyzed. Of this group, 121 patients were classified as the early chronic phase (ECP) group and started IM within 12 months of diagnosis. The other 68 patients were classified as the late chronic phase (LCP) group who had been treated with interferon (IFN)-alpha-2 and crossed over to IM more than 12 months after diagnosis. The overall rates of complete cytogenetic response (CCyR) and major molecular response (MMR) at last follow-up were 83.6 and 78.1% in the ECP and LCP groups, respectively. The CCyR rates were 89.3 (for ECP patients) versus 73.5% (for LCP patients; p < 0.0001). At last follow-up, 82.4% ECP and 64.2% LCP patients had achieved an MMR (p < 0.0001). No significant differences were noted between the two groups with regard to survival outcomes. Our experience reveals that IM is an effective rescue therapy in most CML LCP patients who are intolerant or in whom IFN-alpha therapy fails. Such therapeutic options should be considered in LCP patients, particularly in countries where IM may not be available.

Evaluation of the use, effectiveness and safety of tyrosine kinase inhibitors in chronic myelogenous leukaemia in a general university hospital

“…Of these, 91% presented MMR, with median treatment duration since TKI start of 4.0 years. This duration is comparable to the follow-up time of other retrospective studies, with treatment durations ranging from 2.5 to 4.8 years 7 8…”

The predictive value of early molecular response in chronic myeloid leukaemia patients treated with imatinib in a single real-world medical centre in a developing country

“…(2) In comparison, the percentage of CCyR and MMR among the patients in the present study was 80.0% and 65.7%, respectively, which are comparable to other studies. (15,16) Hence, the results of our study show that a good response can also be achieved in a real-life clinical setting.…”

Low educational level but not low income impairs the achievement of cytogenetic remission in chronic myeloid leukemia patients treated with imatinib in Brazil

“…In the first Brazilian publication on the results of using IM, presented by a center from São Paulo participating in international cooperative studies 8 , 68.8% of the patients starting treatment in the early chronic phase achieved a complete cytogenetic response (CCyR) within 12 months. However, it might be expected that the large social and educational inequalities of the Brazilian population could influence the treatment outcome.…”