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

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
Externally publishedYes

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Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Cytogenetics
Therapeutics
Leukemia, Myeloid, Chronic Phase
Disease-Free Survival
Imatinib Mesylate
Survival Rate

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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Imatinib mesylate dose escalation is associated with durable responses in patients with chronic myeloid leukemia after cytogenetic failure on standard-dose imatinib therapy. / Jabbour, Elias; Kantarjian, Hagop M.; Jones, Dan; Shan, Jenny; O'Brien, Susan; Reddy, Neeli; Wierda, William G.; Faderl, Stefan; Garcia-Manero, Guillermo; Verstovsek, Srdan; Rios, Mary Beth; Cortes, Jorge.

In: Blood, Vol. 113, No. 10, 05.03.2009, p. 2154-2160.

Research output: Contribution to journalArticle

Jabbour, E, Kantarjian, HM, Jones, D, Shan, J, O'Brien, S, Reddy, N, Wierda, WG, Faderl, S, Garcia-Manero, G, Verstovsek, S, Rios, MB & 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, vol. 113, no. 10, pp. 2154-2160. https://doi.org/10.1182/blood-2008-04-154344
Jabbour, Elias ; Kantarjian, Hagop M. ; Jones, Dan ; Shan, Jenny ; O'Brien, Susan ; Reddy, Neeli ; Wierda, William G. ; Faderl, Stefan ; Garcia-Manero, Guillermo ; Verstovsek, Srdan ; Rios, Mary Beth ; Cortes, Jorge. / Imatinib mesylate dose escalation is associated with durable responses in patients with chronic myeloid leukemia after cytogenetic failure on standard-dose imatinib therapy. In: Blood. 2009 ; Vol. 113, No. 10. pp. 2154-2160.
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