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Posted by on Aug 18, 2019 in Leukemia | 0 comments

In a nutshell

This study aimed to investigate treatment response and outcome for patients of 75 years and older with chronic myeloid leukemia treated with imatinib (Gleevec)

This study concluded that imatinib is important in the frontline treatment of these patients. 

Some background

Elderly patients (aged 75 and over) with chronic myeloid leukemia (CML) are sometimes treated with different doses of imatinib (IM) based on associated diseases and doctor's judgment. There is a lack of long-term data on these patients. IM is a targeted therapy called a tyrosine kinase inhibitor (TKI) that can be used to treat various types of cancer. 

The long-term treatment response and outcomes for elderly patients treated with IM were unknown.  

Methods & findings

This study involved 263 patients of 75 years of age and older with CML. All patients received IM from the time of diagnosis. 56% of patients involved had 2 or 3 co-morbidities. Co-morbidities are the presence of one or more additional conditions co-occurring with a primary condition. Patients were followed up for an average of 45 months. 

A complete hematological response (CHR) was achieved in 92.8% of patients. CHR is when the blood count goes back to normal and no leukemia cells are seen. A complete cytogenic response (CCyR) was achieved in 69.9% of patients. CCyR is when no cells with the Philadelphia chromosome (abnormal) can be found in the bone marrow.  

A major molecular response (MMR) was achieved in 56.2% of patients and this was a deep molecular response (DMR) in 24% of cases. MMR is when the majority of the BCR-ABL gene is gone from the blood. BCR-ABL gene is a cancer gene. DMR is a sign that a patient is in remission.  

4.2% of patients experienced a blastic phase of CML. The blastic phase is where there are a high number of blasts (young cells) in the blood and this leads to high production of white blood cells. The frequency of severe hematological (blood-related) and non-hematological side effects was similar to those of younger patients.  

The 5-year event-free survival (EFS; no complications from leukemia or treatment) was 54.5% for patients younger than 80 years. The 5-year EFS was 45.2% for patients older than 80 years.  

The 5-year overall survival (OS) was 75.7% for patients younger than 80 years. The 5-year OS was 61.6% for patients older than 80 years. 

The bottom line

This study concluded that IM is important in the frontline treatment of elderly CML patients without increased side effects. It was also concluded that every effort to treat these patients with standard doses should be made in order to achieve responses as in younger subjects. 

The fine print

This study was based on medical records. Information might not have been complete, which could have affected the results. The study represents "real-life" data, that can apply to most elderly patients.

Published By :

Annals of Hematology

Date :

Aug 07, 2019

Original Title :

Outcome of very elderly chronic myeloid leukaemia patients treated with imatinib frontline.

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