Long-term survival benefit and improved complete cytogenetic and molecular response rates with imatinib mesylate in Philadelphia chromosome-positive chronic-phase chronic myeloid leukemia after failure of interferon-α

Hagop M. Kantarjian, Jorge E. Cortes, Susan O'Brien, Rajyalakshmi Luthra, Francis Giles, Srdan Verstovsek, Stefan Faderl, Deborah Thomas, Guillermo Garcia-Manero, Mary Beth Rios, Jianqin Shan, Dan Jones, Moshe Talpaz

Research output: Contribution to journalReview article

149 Scopus citations

Abstract

We reviewed 261 patients with chronic-phase chronic myelogenous leukemia (CML) after interferon-α (IFN-α) failure treated with imatinib mesylate 400 mg daily. With a median follow-up time of 45 months, the major cytogenetic response rate was 73% and the complete cytogenetic response rate 63%. The estimated 4-year survival rate was 86%. Multivarlate analysis for survival identified hematologic resistance to IFN-α (P = .01), splenomegaly (P = .03), and lack of any cytogenetic response after 3 months of therapy (P = .01) to have independent poor prognostic significance. Patients could be divided into good- (no adverse factors), intermediate-(1 adverse factor), and poor-risk groups (2 or 3 adverse factors; 12% of patients) with estimated 4-year survival rates of 96%, 86%, and 49%, respectively (P < .000 01). The 4-year cumulative major molecular response (quantitative reverse transcriptase-polymerase chain reaction [Q-PCR] = BCR-ABUABL less than 0.05%) rate was 43% and complete molecular response rate (BCR-ABL undetectable) 26%. Compared with a historical group of 251 similar patients treated with nonimatinib therapies, imatinib mesylate was associated with a better 4-year survival rate (86% versus 43%; P < .0001); the survival advantage was confirmed by multivariate analysis (hazard ratio, 0.19; P < .0001).

Original languageEnglish (US)
Pages (from-to)1979-1988
Number of pages10
JournalBlood
Volume104
Issue number7
DOIs
StatePublished - Oct 1 2004
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Kantarjian, H. M., Cortes, J. E., O'Brien, S., Luthra, R., Giles, F., Verstovsek, S., Faderl, S., Thomas, D., Garcia-Manero, G., Rios, M. B., Shan, J., Jones, D., & Talpaz, M. (2004). Long-term survival benefit and improved complete cytogenetic and molecular response rates with imatinib mesylate in Philadelphia chromosome-positive chronic-phase chronic myeloid leukemia after failure of interferon-α. Blood, 104(7), 1979-1988. https://doi.org/10.1182/blood-2004-02-0711