Imatinib in Very Elderly Patients with Chronic Myeloid Leukemia in Chronic Phase: A Retrospective Study

Latagliata, Roberto; Ferrero, Dario; Iurlo, Alessandra; Cavazzini, Francesco; Castagnetti, Fausto; Abruzzese, Elisabetta; Fava, Carmen; Breccia, Massimo; Annunziata, Mario; Stagno, Fabio; Tiribelli, Mario; Binotto, Gianni; Mansueto, Giovanna; Gozzini, Antonella; Russo, Salvatore; Cavalli, Laura; Madon, E; Gugliotta, Gabriele; Cedrone, Michele; Rossi, Antonella Russo; Avanzini, Paolo; Pregno, Patrizia; Echavarría‐Pinto, Mauro; Spadea, Antonio; Celesti, Francesca; Giglio, Gianfranco; Isidori, Alessandro; Crugnola, Monica; Calistri, Elisabetta; Sorà, Federica; Storti, S.; D'Addosio, Ada; Rege‐Cambrin, Giovanna; Luciano, Luigiana; Alimena, Giuliana

doi:10.1007/s40266-013-0088-6

Cited by 37 publications

(23 citation statements)

References 21 publications

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“…However, several older patients actually receive a starting dose of imatinib < 400 mg/day, i.e. lower than the standard dose, owing to worse performance status compared to younger ones [15]. …”

Section: Discussionmentioning

confidence: 99%

Imatinib and polypharmacy in very old patients with chronic myeloid leukemia: effects on response rate, toxicity and outcome

et al. 2016

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BackgroundAbout 40% of all patients with chronic myeloid leukemia are currently old or very old. They are effectively treated with imatinib, even though underrepresented in clinical studies. Furthermore, as it happens in the general population, they often receive multiple drugs for associated chronic illnesses. Aim of this study was to assess whether or not in imatinib-treated patients aged >75 years the exposure to polypharmacy (5 drugs or more) had an impact on cytogenetic and molecular response rates, event-free and overall survival, as well as on hematological or extra-hematological toxicity.Methods296 patients at 35 Italian hematological institutions were evaluated.ResultsPolypharmacy was reported in 107 patients (36.1%), and drugs more frequently used were antiplatelets, diuretics, proton pump inhibitors, ACE-inhibitors, beta-blockers, calcium channel blockers, angiotensin II receptors blockers, statins, oral hypoglycemic drugs and alpha blockers. Complete cytogenetic response was obtained in 174 patients (58.8%), 78 (26.4%) within 6 month, 63 (21.3%) between 7 and 12 months. Major molecular response was obtained in 153 patients (51.7%), 64 (21.6%) within the 12 month. One hundred and twenty-eight cases (43.2%) of hematological toxicity were recorded, together with 167 cases (56.4%) of extra-hematological toxicity. Comparing patients exposed to polypharmacy to those without, no difference was observed pertaining to the dosage of imatinib, cytogenetic and molecular responses and hematological and extra-hematological toxicity.ConclusionNotwithstanding the several interactions reported in the literature between imatinib and some of the medications considered herewith, this fact does not seem to have a clinical impact on response rate and outcome.

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Section: Discussionmentioning

confidence: 99%

Imatinib and polypharmacy in very old patients with chronic myeloid leukemia: effects on response rate, toxicity and outcome

et al. 2016

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“…P450 inhibitors decrease the metabolism of TKI and may enhance their complications. The Italian study10 demonstrated that the achievement of complete cytogenetic response was similar in individuals 75 and older and younger individuals. However a major molecular response was rarer.…”

Section: Age and Pharmacology Of Tkimentioning

confidence: 97%

“…While it is still possible that age-associated immune dysfunctions or age-related changes in hematopoietic stroma may lead to a more aggressive disease, at present there is no conclusive evidence that the biology of CML changes with age. As older patients appear to benefit from TKI to the same extent as the young1,9–10 one may conclude that age-related biological differences do not seem to impact the prognosis of CML in the elderly.…”

Section: Biology Of CML and Agingmentioning

confidence: 99%

“…It is not farfetched to assume that competitive causes of death and inadequate treatment might have played a major role. An Italian study involving 31 medical centers10 showed that patients aged 75+ seemed to benefit from imatinib treatment to the same extent as younger people. It is not clear to what degree these patients have been selected however.…”

Section: Age and Survival Of CML Patients In The Imatinib Eramentioning

confidence: 99%

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Chronic Myelogenous Leukemia (Cml) in the Elderly

Balducci¹

2014

Mediterr J Hematol Infect Dis

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“…This information is critical, given the rapid development of new oral antineoplastic agents during the past two decades. Data limited to imatinib [ 29 ] and oral idarubicin [ 30 ] suggest that the absorption of oral agents is unaffected by age. These studies included only elderly in good general conditions and under 85.…”

Section: Pharmacology Of Agingmentioning

confidence: 99%

Systemic Treatment of Cancer in the Older-Aged Person

Balducci

2016

Ovarian Cancer in Elderly Patients

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Imatinib in Very Elderly Patients with Chronic Myeloid Leukemia in Chronic Phase: A Retrospective Study

Cited by 37 publications

References 21 publications

Imatinib and polypharmacy in very old patients with chronic myeloid leukemia: effects on response rate, toxicity and outcome

Imatinib and polypharmacy in very old patients with chronic myeloid leukemia: effects on response rate, toxicity and outcome

Chronic Myelogenous Leukemia (Cml) in the Elderly

Systemic Treatment of Cancer in the Older-Aged Person

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