Imatinib mesylate dose escalation is associated with durable responses in patients with chronic myeloid leukemia after cytogenetic failure on standard-dose imatinib therapy

Elias Jabbour, Hagop M. Kantarjian, Dan Jones, Jenny Shan, Susan O'Brien, Neeli Reddy, William G. Wierda, Stefan Faderl, Guillermo Garcia-Manero, Srdan Verstovsek, Mary Beth Rios, Jorge Cortes

Research output: Contribution to journalArticle

113 Scopus citations

Abstract

We assessed the long-term efficacy of imatinib dose escalation in 84 patients with chronic myeloid leukemia in chronic phase who met the criteria of failure to standard-dose imatinib. Twenty-one patients with hematologic failure and 63 with cytogenetic failure had their imatinib dose escalated from 400 to 800 mg daily (n = 72) or from 300 to 600 mg daily (n = 12). After a median follow-up of 61 months from dose escalation, 69% remained alive. Complete cytogenetic responses were achieved in 40%; including 52% of patients with cytogenetic failure and 5% of those with hematologic failure. The estimated 2-and 3-year event-free survival and overall survival rates were 57% and 47%, and 84% and 76%, respectively. Responses were long-lasting; 88% of patients with major cytogenetic response sustained their response beyond 2 years. Treatment was well tolerated, with 76% of patients, at 12 months, continuing to receive imatinib at 100% of the intended dose. In conclusion, imatinib dose escalation can induce sustained responses in a subset of patients with cytogenetic failure and a previous cytogenetic response to standard-dose imatinib.

Original languageEnglish (US)
Pages (from-to)2154-2160
Number of pages7
JournalBlood
Volume113
Issue number10
DOIs
StatePublished - Mar 5 2009

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Jabbour, E., Kantarjian, H. M., Jones, D., Shan, J., O'Brien, S., Reddy, N., Wierda, W. G., Faderl, S., Garcia-Manero, G., Verstovsek, S., Rios, M. B., & Cortes, J. (2009). Imatinib mesylate dose escalation is associated with durable responses in patients with chronic myeloid leukemia after cytogenetic failure on standard-dose imatinib therapy. Blood, 113(10), 2154-2160. https://doi.org/10.1182/blood-2008-04-154344