Analysis of 2013 European LeukaemiaNet (ELN) responses in chronic phase CML across four frontline TKI modalities and impact on clinical outcomes

Preetesh Jain, Hagop Kantarjian, Koji Sasaki, Elias Jabbour, Jyothsna Dasarathula, Graciela Nogueras Gonzalez, Srdan Verstovsek, Gautam Borthakur, William Wierda, Tapan Kadia, Sara Dellasala, Sherry Pierce, Farhad Ravandi, Susan O'Brien, Jorge Cortes

Research output: Contribution to journalArticle

Abstract

This study assessed the relevance of 2013 European LeukaemiaNet (ELN) response categories on patients treated with common frontline tyrosine kinase inhibitors (TKI) in chronic myeloid leukaemia in chronic phase (CML-CP). Four hundred and eighty-seven patients treated with imatinib (400 mg; IM 400, n = 70; 800 mg; IM800, n = 201), dasatinib (n = 107) or nilotinib (n = 109) were analysed. Intention to treat (ITT) analysis indicated that the proportion of patients falling into optimal, warning and failure ELN categories were 89%, 6%, 6% at 3 months, 78%, 17% and 6% at 6 months, and 75%, 13% and 13% at 12 months, respectively. Rates of optimal response at 3 months were 75% for IM400, 90% for IM800, 89% for dasatinib and 97% for nilotinib; 41%, 80%, 86% and 89% at 6 months; and 47%, 77%, 76% and 87% at 12 months, respectively. Patients achieving optimal response had longer eventfree (EFS), failurefree (FFS), transformationfree (TFS) and overall survival (OS) compared to warning and failure responses at all-time points. Treatment with imatinib 800, dasatinib or nilotinib predicted for achieving an optimal response. Optimal response predicted for significantly longer EFS, FFS, TFS and OS at 3, 6 and 12 months, irrespective of the TKI modality used. ELN response categories reliably predicted outcomes in CML patients receiving commonly used TKIs.

Original languageEnglish (US)
Pages (from-to)114-126
Number of pages13
JournalBritish Journal of Haematology
Volume173
Issue number1
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

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Protein-Tyrosine Kinases
Leukemia, Myeloid, Chronic Phase
Intention to Treat Analysis
Survival
4-methyl-N-(3-(4-methylimidazol-1-yl)-5-(trifluoromethyl)phenyl)-3-((4-pyridin-3-ylpyrimidin-2-yl)amino)benzamide
Dasatinib
Imatinib Mesylate
Therapeutics

Keywords

  • Chronic myeloid leukaemia
  • ELN
  • European LeukaemiaNet
  • Response in CML
  • Tyrosine kinase inhibitor (TKI)

ASJC Scopus subject areas

  • Hematology

Cite this

Analysis of 2013 European LeukaemiaNet (ELN) responses in chronic phase CML across four frontline TKI modalities and impact on clinical outcomes. / Jain, Preetesh; Kantarjian, Hagop; Sasaki, Koji; Jabbour, Elias; Dasarathula, Jyothsna; Nogueras Gonzalez, Graciela; Verstovsek, Srdan; Borthakur, Gautam; Wierda, William; Kadia, Tapan; Dellasala, Sara; Pierce, Sherry; Ravandi, Farhad; O'Brien, Susan; Cortes, Jorge.

In: British Journal of Haematology, Vol. 173, No. 1, 01.04.2016, p. 114-126.

Research output: Contribution to journalArticle

Jain, P, Kantarjian, H, Sasaki, K, Jabbour, E, Dasarathula, J, Nogueras Gonzalez, G, Verstovsek, S, Borthakur, G, Wierda, W, Kadia, T, Dellasala, S, Pierce, S, Ravandi, F, O'Brien, S & Cortes, J 2016, 'Analysis of 2013 European LeukaemiaNet (ELN) responses in chronic phase CML across four frontline TKI modalities and impact on clinical outcomes', British Journal of Haematology, vol. 173, no. 1, pp. 114-126. https://doi.org/10.1111/bjh.13936
Jain, Preetesh ; Kantarjian, Hagop ; Sasaki, Koji ; Jabbour, Elias ; Dasarathula, Jyothsna ; Nogueras Gonzalez, Graciela ; Verstovsek, Srdan ; Borthakur, Gautam ; Wierda, William ; Kadia, Tapan ; Dellasala, Sara ; Pierce, Sherry ; Ravandi, Farhad ; O'Brien, Susan ; Cortes, Jorge. / Analysis of 2013 European LeukaemiaNet (ELN) responses in chronic phase CML across four frontline TKI modalities and impact on clinical outcomes. In: British Journal of Haematology. 2016 ; Vol. 173, No. 1. pp. 114-126.
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abstract = "This study assessed the relevance of 2013 European LeukaemiaNet (ELN) response categories on patients treated with common frontline tyrosine kinase inhibitors (TKI) in chronic myeloid leukaemia in chronic phase (CML-CP). Four hundred and eighty-seven patients treated with imatinib (400 mg; IM 400, n = 70; 800 mg; IM800, n = 201), dasatinib (n = 107) or nilotinib (n = 109) were analysed. Intention to treat (ITT) analysis indicated that the proportion of patients falling into optimal, warning and failure ELN categories were 89{\%}, 6{\%}, 6{\%} at 3 months, 78{\%}, 17{\%} and 6{\%} at 6 months, and 75{\%}, 13{\%} and 13{\%} at 12 months, respectively. Rates of optimal response at 3 months were 75{\%} for IM400, 90{\%} for IM800, 89{\%} for dasatinib and 97{\%} for nilotinib; 41{\%}, 80{\%}, 86{\%} and 89{\%} at 6 months; and 47{\%}, 77{\%}, 76{\%} and 87{\%} at 12 months, respectively. Patients achieving optimal response had longer eventfree (EFS), failurefree (FFS), transformationfree (TFS) and overall survival (OS) compared to warning and failure responses at all-time points. Treatment with imatinib 800, dasatinib or nilotinib predicted for achieving an optimal response. Optimal response predicted for significantly longer EFS, FFS, TFS and OS at 3, 6 and 12 months, irrespective of the TKI modality used. ELN response categories reliably predicted outcomes in CML patients receiving commonly used TKIs.",
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AU - Borthakur, Gautam

AU - Wierda, William

AU - Kadia, Tapan

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N2 - This study assessed the relevance of 2013 European LeukaemiaNet (ELN) response categories on patients treated with common frontline tyrosine kinase inhibitors (TKI) in chronic myeloid leukaemia in chronic phase (CML-CP). Four hundred and eighty-seven patients treated with imatinib (400 mg; IM 400, n = 70; 800 mg; IM800, n = 201), dasatinib (n = 107) or nilotinib (n = 109) were analysed. Intention to treat (ITT) analysis indicated that the proportion of patients falling into optimal, warning and failure ELN categories were 89%, 6%, 6% at 3 months, 78%, 17% and 6% at 6 months, and 75%, 13% and 13% at 12 months, respectively. Rates of optimal response at 3 months were 75% for IM400, 90% for IM800, 89% for dasatinib and 97% for nilotinib; 41%, 80%, 86% and 89% at 6 months; and 47%, 77%, 76% and 87% at 12 months, respectively. Patients achieving optimal response had longer eventfree (EFS), failurefree (FFS), transformationfree (TFS) and overall survival (OS) compared to warning and failure responses at all-time points. Treatment with imatinib 800, dasatinib or nilotinib predicted for achieving an optimal response. Optimal response predicted for significantly longer EFS, FFS, TFS and OS at 3, 6 and 12 months, irrespective of the TKI modality used. ELN response categories reliably predicted outcomes in CML patients receiving commonly used TKIs.

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