High-dose imatinib mesylate therapy in newly diagnosed Philadelphia chromosome-positive chronic phase chronic myeloid leukemia

Hagop Kantarjian, Moshe Talpaz, Susan O'Brien, Guillermo Garcia-Manero, Srdan Verstovsek, Francis Giles, Mary Beth Rios, Jianqin Shan, Laurie Letvak, Deborah Thomas, Stefan Faderl, Alessandra Ferrajoli, Jorge Cortes

Research output: Contribution to journalArticle

349 Scopus citations

Abstract

Imatinib mesylate (STI571) is effective in chronic phase chronic myelogenous leukemia (CML). However, most patients treated with 400 mg imatinib daily have variable levels of residual molecular disease. We treated 114 patients with newly diagnosed chronic phase CML with 400 mg imatinib twice daily. Overall, 109 patients (96%) had a major cytogenetic response (Philadelphia chromosome [Ph] < 35%), and 103 (90%) had a complete response (Ph 0%). With a median follow-up of 15 months, no patient has progressed to accelerated or blastic phase. The estimated 2-year survival rate was 94%. By quantitative polymerase chain reaction (QPCR) studies, 71 (63%) of 112 patients showed BCR-ABL/ABL percentage ratios decrease to less than 0.05%, and 31 (28%) to undetectable levels. Compared with standard-dose imatinib, high-dose imatinib was associated with significantly better complete cytogenetic response (P = .0005), major molecular response (QPRC < 0.05%; P = .00001), and complete molecular response (undetectable BCR-ABL; P = .001). High-dose imatinib was well tolerated but resulted in more frequent myelosuppression; 82% of patients continue to receive 600 mg or more of imatinib daily. In conclusion, high-dose imatinib induced higher rates of complete cytogenetic response and of molecular response in patients with newly diagnosed chronic phase CML.

Original languageEnglish (US)
Pages (from-to)2873-2878
Number of pages6
JournalBlood
Volume103
Issue number8
DOIs
StatePublished - Apr 15 2004
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Kantarjian, H., Talpaz, M., O'Brien, S., Garcia-Manero, G., Verstovsek, S., Giles, F., Rios, M. B., Shan, J., Letvak, L., Thomas, D., Faderl, S., Ferrajoli, A., & Cortes, J. (2004). High-dose imatinib mesylate therapy in newly diagnosed Philadelphia chromosome-positive chronic phase chronic myeloid leukemia. Blood, 103(8), 2873-2878. https://doi.org/10.1182/blood-2003-11-3800