Long-term prognostic impact of the use of erythropoietic-stimulating agents in patients with chronic myeloid leukemia in chronic phase treated with imatinib

Fabio P.S. Santos, Yesid Alvarado, Hagop Kantarjian, Dushyant Verma, Susan O'Brien, Gloria Mattiuzzi, Farhad Ravandi, Gautam Borthakur, Jorge Cortes

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Anemia is a frequent side effect of imatinib in patients with chronic myeloid leukemia (CML). Erythropoietic-stimulating agents have been used for treatment of imatinib-induced anemia. There are no data on long-term safety of erythropoietic-stimulating agents in CML patients. METHODS: The records of chronic phase CML patients who received treatment with imatinib were reviewed for use of erythropoietic-stimulating agents and occurrence of thrombotic events. Data on cytogenetic response and survival were analyzed by use of erythropoietic-stimulating agent. RESULTS: A total of 608 patients were included, and 217 patients received erythropoietic-stimulating agents. There were 30 thrombotic episodes. Patients who received erythropoietic-stimulating agents had a higher rate of thrombosis (8.5% vs 2.6%, P = .0025). There was no difference in cytogenetic response rate and survival by use of erythropoietic-stimulating agent. Development of grade 3-4 anemia occurred in 62 (10%) patients and was associated with significantly worse response and survival in patients in late chronic phase. By multivariate analysis, use of erythropoietic-stimulating agents was not a risk factor for event-free survival. CONCLUSIONS: In our cohort of chronic phase CML patients, use of erythropoietic-stimulating agents did not impact survival or cytogenetic response rate, but was associated with a higher thrombosis rate. Severe anemia is associated with worse survival and response.

Original languageEnglish (US)
Pages (from-to)982-991
Number of pages10
JournalCancer
Volume117
Issue number5
DOIs
StatePublished - Mar 1 2011
Externally publishedYes

Fingerprint

Leukemia, Myeloid, Chronic Phase
Proxy
Anemia
Cytogenetics
Survival
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Thrombosis
Imatinib Mesylate
Disease-Free Survival
Multivariate Analysis
Survival Rate
Safety

Keywords

  • Anemia
  • Chronic myeloid leukemia
  • Erythropoiesis-stimulating agents
  • Imatinib
  • Tyrosine kinase inhibitors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Long-term prognostic impact of the use of erythropoietic-stimulating agents in patients with chronic myeloid leukemia in chronic phase treated with imatinib. / Santos, Fabio P.S.; Alvarado, Yesid; Kantarjian, Hagop; Verma, Dushyant; O'Brien, Susan; Mattiuzzi, Gloria; Ravandi, Farhad; Borthakur, Gautam; Cortes, Jorge.

In: Cancer, Vol. 117, No. 5, 01.03.2011, p. 982-991.

Research output: Contribution to journalArticle

Santos, FPS, Alvarado, Y, Kantarjian, H, Verma, D, O'Brien, S, Mattiuzzi, G, Ravandi, F, Borthakur, G & Cortes, J 2011, 'Long-term prognostic impact of the use of erythropoietic-stimulating agents in patients with chronic myeloid leukemia in chronic phase treated with imatinib', Cancer, vol. 117, no. 5, pp. 982-991. https://doi.org/10.1002/cncr.25533
Santos, Fabio P.S. ; Alvarado, Yesid ; Kantarjian, Hagop ; Verma, Dushyant ; O'Brien, Susan ; Mattiuzzi, Gloria ; Ravandi, Farhad ; Borthakur, Gautam ; Cortes, Jorge. / Long-term prognostic impact of the use of erythropoietic-stimulating agents in patients with chronic myeloid leukemia in chronic phase treated with imatinib. In: Cancer. 2011 ; Vol. 117, No. 5. pp. 982-991.
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AU - Santos, Fabio P.S.

AU - Alvarado, Yesid

AU - Kantarjian, Hagop

AU - Verma, Dushyant

AU - O'Brien, Susan

AU - Mattiuzzi, Gloria

AU - Ravandi, Farhad

AU - Borthakur, Gautam

AU - Cortes, Jorge

PY - 2011/3/1

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N2 - BACKGROUND: Anemia is a frequent side effect of imatinib in patients with chronic myeloid leukemia (CML). Erythropoietic-stimulating agents have been used for treatment of imatinib-induced anemia. There are no data on long-term safety of erythropoietic-stimulating agents in CML patients. METHODS: The records of chronic phase CML patients who received treatment with imatinib were reviewed for use of erythropoietic-stimulating agents and occurrence of thrombotic events. Data on cytogenetic response and survival were analyzed by use of erythropoietic-stimulating agent. RESULTS: A total of 608 patients were included, and 217 patients received erythropoietic-stimulating agents. There were 30 thrombotic episodes. Patients who received erythropoietic-stimulating agents had a higher rate of thrombosis (8.5% vs 2.6%, P = .0025). There was no difference in cytogenetic response rate and survival by use of erythropoietic-stimulating agent. Development of grade 3-4 anemia occurred in 62 (10%) patients and was associated with significantly worse response and survival in patients in late chronic phase. By multivariate analysis, use of erythropoietic-stimulating agents was not a risk factor for event-free survival. CONCLUSIONS: In our cohort of chronic phase CML patients, use of erythropoietic-stimulating agents did not impact survival or cytogenetic response rate, but was associated with a higher thrombosis rate. Severe anemia is associated with worse survival and response.

AB - BACKGROUND: Anemia is a frequent side effect of imatinib in patients with chronic myeloid leukemia (CML). Erythropoietic-stimulating agents have been used for treatment of imatinib-induced anemia. There are no data on long-term safety of erythropoietic-stimulating agents in CML patients. METHODS: The records of chronic phase CML patients who received treatment with imatinib were reviewed for use of erythropoietic-stimulating agents and occurrence of thrombotic events. Data on cytogenetic response and survival were analyzed by use of erythropoietic-stimulating agent. RESULTS: A total of 608 patients were included, and 217 patients received erythropoietic-stimulating agents. There were 30 thrombotic episodes. Patients who received erythropoietic-stimulating agents had a higher rate of thrombosis (8.5% vs 2.6%, P = .0025). There was no difference in cytogenetic response rate and survival by use of erythropoietic-stimulating agent. Development of grade 3-4 anemia occurred in 62 (10%) patients and was associated with significantly worse response and survival in patients in late chronic phase. By multivariate analysis, use of erythropoietic-stimulating agents was not a risk factor for event-free survival. CONCLUSIONS: In our cohort of chronic phase CML patients, use of erythropoietic-stimulating agents did not impact survival or cytogenetic response rate, but was associated with a higher thrombosis rate. Severe anemia is associated with worse survival and response.

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KW - Chronic myeloid leukemia

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KW - Imatinib

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