Impact of frontline treatment approach on outcomes of myeloid blast phase CML

Saxena, Kapil; Jabbour, Elias; Issa, Ghayas C.; Sasaki, Koji; Ravandi, Farhad; Maiti, Abhishek; Kadia, Tapan M.; DiNardo, Courtney D.; Konopleva, Marina; Cortes, Jorge; Yılmaz, Musa; Chien, Kelly S.; Pierce, Sherry; Kantarjian, Hagop M.

doi:10.1186/s13045-021-01106-1

Cited by 27 publications

(14 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The use of hypomethylating agents such as decitabine might improve the treatment of CML as previously demonstrated for myelodysplastic diseases such as chronic myelomonocytic leukemia (CMML) [ 30 ]. Retrospective analysis has shown that combined front-line treatment with a second- or third-generation TKI and a hypomethylating agent or intensive chemotherapy leads to improved response rates and outcome in myeloid blastic crisis followed by allogeneic stem cell transplantation [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

Potential to Improve Therapy of Chronic Myeloid Leukemia (CML), Especially for Patients with Older Age: Incidence, Mortality, and Survival Rates of Patients with CML in Switzerland from 1995 to 2017

Daskalakis

Feller

Noetzli

et al. 2021

Cancers

View full text Add to dashboard Cite

Background: Tyrosine kinase inhibitors (TKI) substantially improved chronic myeloid leukemia (CML) prognosis. We aimed to describe time period- and age-dependent outcomes by reporting real-world data of CML patients from Switzerland. Methods: Population-based incidence, mortality, and survival were assessed for four different study periods and age groups on the basis of aggregated data from Swiss Cantonal Cancer Registries. Results: A total of 1552 new CML cases were reported from 1995 to 2017. The age-standardized rate (ASR) for the incidence remained stable, while the ASR for mortality decreased by 50–80%, resulting in a five-year RS from 36% to 74% over all four age groups. Importantly, for patients <60 years (yrs), the five-year RS increased only in earlier time periods up to 92%, whereas for older patients (+80 yrs), the five-year RS continued to increase later, however, reaching only 53% until 2017. Conclusions: This is the first population-based study of CML patients in Switzerland confirming similar data compared to other population-based registries in Europe. The RS increased significantly in all age groups over the last decades after the establishment of TKI therapy. Interestingly, we found a more prominent increase in RS of patients with older age at later observation periods (45%) compared to patients at younger age (10%), implicating a greater benefit from TKI treatment for elderly occurring with delay since the establishment of TKI therapy. Our findings suggest more potential to improve CML therapy, especially for older patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Potential to Improve Therapy of Chronic Myeloid Leukemia (CML), Especially for Patients with Older Age: Incidence, Mortality, and Survival Rates of Patients with CML in Switzerland from 1995 to 2017

Daskalakis

Feller

Noetzli

et al. 2021

Cancers

View full text Add to dashboard Cite

show abstract

“…A novel strategy is required for the optimal selection of TKI therapies during long-term therapy (85). After achieving treatment-free remission, monitoring of BCR::ABL1 transcript levels is still requiredto detect loss of MMR early and restart TKI therapy even with novel therapies (86)(87)(88)(89)(90)(91). Eltrombopag can be considered in managing TKI-related thrombocytopenia during TKI therapy (92).…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

Adverse events and dose modifications of tyrosine kinase inhibitors in chronic myelogenous leukemia

Yoshifuji

Sasaki

2022

Front. Oncol.

View full text Add to dashboard Cite

The prognosis of chronic myelogenous leukemia (CML-CP) in chronic phase has improved dramatically since the introduction of imatinib. In addition to imatinib, second- and third-generation tyrosine kinase inhibitors (TKIs) and a novel allosteric inhibitor, asciminib, are now available. During long-term TKI therapy, the optimal selection of TKI therapy for individual patients requires the understanding of specific patterns of toxicity profile to minimize chronic toxicity and the risk of adverse events, including pulmonary arterial hypertension, pleural effusion, and cardiovascular events. Given the high efficacy of TKI therapy, dose modifications of TKI therapy reduce the risk of toxicities and improves quality of life during therapy. In this review article, we summarize the characteristics and adverse event profile of each TKI and dose modifications in patients with CML-CP and discuss future perspectives in the treatment of CML-CP.

show abstract

“…Long-term survival rates were similar between IC + TKI and HMA + TKI, with a long-term survival rate of around 30% and improved outcomes for patients who were able to undergo ASCT (allogeneic stem cell transplant). However, while being less intensive than an IC method, the combination of HMA and second/third generation TKI is extremely successful (Saxena et al, 2021). As a result of their poor prognosis, patients with CML-BP require novel treatment options (Jain et al, 2017).…”

Section: Concomitant Use Of Tki and Ic/hma In Myeloid Bp-cml Patientsmentioning

confidence: 99%

A Review on the Therapeutic Role of TKIs in Case of CML in Combination With Epigenetic Drugs

Amir

Javed

2021

Front. Genet.

View full text Add to dashboard Cite

Chronic myeloid leukemia is a malignancy of bone marrow that affects white blood cells. There is strong evidence that disease progression, treatment responses, and overall clinical outcomes of CML patients are influenced by the accumulation of other genetic and epigenetic abnormalities, rather than only the BCR/ABL1 oncoprotein. Both genetic and epigenetic factors influence the efficacy of CML treatment strategies. Targeted medicines known as tyrosine-kinase inhibitors have dramatically improved long-term survival rates in CML patients during the previous 2 decades. When compared to earlier chemotherapy treatments, these drugs have revolutionized CML treatment and allowed most people to live longer lives. Although epigenetic inhibitors’ activity is disrupted in many cancers, including CML, but when combined with TKI, they may offer potential therapeutic strategies for the treatment of CML cells. The epigenetics of tyrosine kinase inhibitors and resistance to them is being studied, with a particular focus on imatinib, which is used to treat CML. In addition, the use of epigenetic drugs in conjunction with TKIs has been discussed. Resistance to TKIs is still a problem in curing the disease, necessitating the development of new therapies. This study focused on epigenetic pathways involved in CML pathogenesis and tumor cell resistance to TKIs, both of which contribute to leukemic clone breakout and proliferation.

show abstract

Impact of frontline treatment approach on outcomes of myeloid blast phase CML

Cited by 27 publications

References 36 publications

Potential to Improve Therapy of Chronic Myeloid Leukemia (CML), Especially for Patients with Older Age: Incidence, Mortality, and Survival Rates of Patients with CML in Switzerland from 1995 to 2017

Potential to Improve Therapy of Chronic Myeloid Leukemia (CML), Especially for Patients with Older Age: Incidence, Mortality, and Survival Rates of Patients with CML in Switzerland from 1995 to 2017

Adverse events and dose modifications of tyrosine kinase inhibitors in chronic myelogenous leukemia

A Review on the Therapeutic Role of TKIs in Case of CML in Combination With Epigenetic Drugs

Contact Info

Product

Resources

About