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

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

Fingerprint

Leukemia, Myeloid, Chronic Phase
Philadelphia Chromosome
Chromosomes
Cytogenetics
Interferons
Survival
Survival Rate
Polymerase chain reaction
RNA-Directed DNA Polymerase
Hazards
Splenomegaly
Survival Analysis
Reverse Transcriptase Polymerase Chain Reaction
Multivariate Analysis
Imatinib Mesylate
Therapeutics

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

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

In: Blood, Vol. 104, No. 7, 01.10.2004, p. 1979-1988.

Research output: Contribution to journalReview article

Kantarjian, HM, Cortes, JE, O'Brien, S, Luthra, R, Giles, F, Verstovsek, S, Faderl, S, Thomas, D, Garcia-Manero, G, Rios, MB, 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, vol. 104, no. 7, pp. 1979-1988. https://doi.org/10.1182/blood-2004-02-0711
Kantarjian, Hagop M. ; Cortes, Jorge E. ; O'Brien, Susan ; Luthra, Rajyalakshmi ; Giles, Francis ; Verstovsek, Srdan ; Faderl, Stefan ; Thomas, Deborah ; Garcia-Manero, Guillermo ; Rios, Mary Beth ; Shan, Jianqin ; Jones, Dan ; Talpaz, Moshe. / 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. In: Blood. 2004 ; Vol. 104, No. 7. pp. 1979-1988.
@article{a8df2cde770046aa81c5790c178fd0f2,
title = "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",
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).",
author = "Kantarjian, {Hagop M.} and Cortes, {Jorge E.} and Susan O'Brien and Rajyalakshmi Luthra and Francis Giles and Srdan Verstovsek and Stefan Faderl and Deborah Thomas and Guillermo Garcia-Manero and Rios, {Mary Beth} and Jianqin Shan and Dan Jones and Moshe Talpaz",
year = "2004",
month = "10",
day = "1",
doi = "10.1182/blood-2004-02-0711",
language = "English (US)",
volume = "104",
pages = "1979--1988",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "7",

}

TY - JOUR

T1 - 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

AU - Kantarjian, Hagop M.

AU - Cortes, Jorge E.

AU - O'Brien, Susan

AU - Luthra, Rajyalakshmi

AU - Giles, Francis

AU - Verstovsek, Srdan

AU - Faderl, Stefan

AU - Thomas, Deborah

AU - Garcia-Manero, Guillermo

AU - Rios, Mary Beth

AU - Shan, Jianqin

AU - Jones, Dan

AU - Talpaz, Moshe

PY - 2004/10/1

Y1 - 2004/10/1

N2 - 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).

AB - 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).

UR - http://www.scopus.com/inward/record.url?scp=4644359704&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4644359704&partnerID=8YFLogxK

U2 - 10.1182/blood-2004-02-0711

DO - 10.1182/blood-2004-02-0711

M3 - Review article

C2 - 15198956

AN - SCOPUS:4644359704

VL - 104

SP - 1979

EP - 1988

JO - Blood

JF - Blood

SN - 0006-4971

IS - 7

ER -