Evaluating first-line imatinib for elderly patients with chronic myeloid leukemia

This study compared the effects of age and treatment dose for imatinib (Gleevec) in elderly versus younger patients with chronic myeloid leukemia (CML). This study concluded older patients had similar responses to therapy compared to younger patients.

Tyrosine kinase (TK) inhibitors are the standard therapy for chronic myeloid leukemia. TK inhibitors are a type of targeted therapy. This treatment blocks cancer cell survival. This leads to cancer cell death. Imatinib is one commonly used targeted therapy for CML.

TK inhibitors have helped improve outcomes for many patients with CML. However, most studies evaluating these agents do not include patients older than 70. The outcomes of TK inhibitor treatment for patients older than 65 compared to younger patients remain under investigation.

This study involved 372 patients with CML. This study did two separate analyses. In the first analysis, 80 elderly patients (age 65 or older) were compared to 292 younger patients. In the second analysis, 202 patients aged 40 – 64 were compared to 90 patients younger than age 40. All patients received first-line treatment with imatinib. Patients were followed-up for an average of 82.3 months.

In the first analysis, 91.8% (elderly) versus 92.3% (younger) had a complete disappearance of all signs of CML. On average, this response was achieved at an average of 2.9 versus 3 months of treatment. Age did not have a significant effect on the response to treatment in this analysis.

In the second analysis, 91.7% of young adults and 92.6% of adults had a complete disappearance of all signs of CML. 91.8% of elderly adults had this response. Age did not have a significant effect on the response to treatment in this analysis.

The probability of surviving for 10 years after treatment was significantly higher in patients younger than 65 compared to patients aged 65 or older (83.7% vs. 68.1%). In patients younger than 40, the probability of surviving for 10 years after treatment was highest (90.6%).

With a daily dose of 400 milligrams, 85.7% of patients were still alive 10 years later without tumor growth or spread. With a daily dose lower than 400 milligrams, this rate was 77.1%.

This study concluded that response to treatment was similar in all age groups. However, long-term survival was significantly better in younger patients with CML compared to patients aged 65 or older. The authors suggest that consistent imatinib dosage is important for elderly patients.

This study was retrospective, meaning it looked back in time to analyze data. More studies are needed to confirm these results.