The achievement of a 3-month complete cytogenetic response to second-generation tyrosine Kinase inhibitors predicts survival in patients with chronic phase chronic myeloid leukemia after imatinib failure

Elias Jabbour, Hagop Kantarjian, Hady Ghanem, Susan O'Brien, Alfonso Quintas-Cardama, Guillermo Garcia-Manero, Marylou Cardenas, Jorge Cortes

Research output: Contribution to journalArticle

Abstract

Background: We assessed whether the achievement of a 3-month complete cytogenetic response (CCyR) in 123 patients with chronic myeloid leukemia (CML) in the chronic phase, which was treated with second-generation tyrosine kinase inhibitors (2nd-TKI) after imatinib failure could predict for survival. Patients and Methods: In a multivariate analysis, the lack of a 3-month CCyR to 2nd-TKI therapy was selected as the only independent factor associated with poor event-free survival (hazard ratio [HR] 4.5; P <.001) and overall survival (5.4; P =.03). Results: The 3-year event-free survival and overall survival rates were 74% and 43%, respectively, for patients with 3-month CCyR, and were 98% and 79%, respectively, for patients without 3-month CCyR. In a multivariate analysis, high hemoglobin level, previous major cytogenetic response to imatinib therapy, and ≤90% Philadelphia-positive metaphases were associated with the achievement of a 3-month CCyR. Conclusion: The achievement of a 3-month CCyR is the only predictor of outcome in patients treated with 2nd-TKI therapy after imatinib failure. Patients with <3-month CCyR may not obtain long-term benefit and should be followed-up closely.

Original languageEnglish (US)
Pages (from-to)302-306
Number of pages5
JournalClinical Lymphoma, Myeloma and Leukemia
Volume13
Issue number3
DOIs
StatePublished - Jun 1 2013
Externally publishedYes

Fingerprint

Leukemia, Myeloid, Chronic Phase
Cytogenetics
Protein-Tyrosine Kinases
Survival
Disease-Free Survival
Multivariate Analysis
Imatinib Mesylate
Metaphase
Hemoglobins
Therapeutics
Survival Rate

Keywords

  • Chronic myeloid leukemia
  • Cytogenetic response
  • Prognosis
  • Tyrosine kinase inhibitor

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

The achievement of a 3-month complete cytogenetic response to second-generation tyrosine Kinase inhibitors predicts survival in patients with chronic phase chronic myeloid leukemia after imatinib failure. / Jabbour, Elias; Kantarjian, Hagop; Ghanem, Hady; O'Brien, Susan; Quintas-Cardama, Alfonso; Garcia-Manero, Guillermo; Cardenas, Marylou; Cortes, Jorge.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 13, No. 3, 01.06.2013, p. 302-306.

Research output: Contribution to journalArticle

Jabbour, Elias ; Kantarjian, Hagop ; Ghanem, Hady ; O'Brien, Susan ; Quintas-Cardama, Alfonso ; Garcia-Manero, Guillermo ; Cardenas, Marylou ; Cortes, Jorge. / The achievement of a 3-month complete cytogenetic response to second-generation tyrosine Kinase inhibitors predicts survival in patients with chronic phase chronic myeloid leukemia after imatinib failure. In: Clinical Lymphoma, Myeloma and Leukemia. 2013 ; Vol. 13, No. 3. pp. 302-306.
@article{068f1bebeb704eb69ac5bad2443166ef,
title = "The achievement of a 3-month complete cytogenetic response to second-generation tyrosine Kinase inhibitors predicts survival in patients with chronic phase chronic myeloid leukemia after imatinib failure",
abstract = "Background: We assessed whether the achievement of a 3-month complete cytogenetic response (CCyR) in 123 patients with chronic myeloid leukemia (CML) in the chronic phase, which was treated with second-generation tyrosine kinase inhibitors (2nd-TKI) after imatinib failure could predict for survival. Patients and Methods: In a multivariate analysis, the lack of a 3-month CCyR to 2nd-TKI therapy was selected as the only independent factor associated with poor event-free survival (hazard ratio [HR] 4.5; P <.001) and overall survival (5.4; P =.03). Results: The 3-year event-free survival and overall survival rates were 74{\%} and 43{\%}, respectively, for patients with 3-month CCyR, and were 98{\%} and 79{\%}, respectively, for patients without 3-month CCyR. In a multivariate analysis, high hemoglobin level, previous major cytogenetic response to imatinib therapy, and ≤90{\%} Philadelphia-positive metaphases were associated with the achievement of a 3-month CCyR. Conclusion: The achievement of a 3-month CCyR is the only predictor of outcome in patients treated with 2nd-TKI therapy after imatinib failure. Patients with <3-month CCyR may not obtain long-term benefit and should be followed-up closely.",
keywords = "Chronic myeloid leukemia, Cytogenetic response, Prognosis, Tyrosine kinase inhibitor",
author = "Elias Jabbour and Hagop Kantarjian and Hady Ghanem and Susan O'Brien and Alfonso Quintas-Cardama and Guillermo Garcia-Manero and Marylou Cardenas and Jorge Cortes",
year = "2013",
month = "6",
day = "1",
doi = "10.1016/j.clml.2012.12.005",
language = "English (US)",
volume = "13",
pages = "302--306",
journal = "Clinical Lymphoma, Myeloma and Leukemia",
issn = "2152-2650",
publisher = "Cancer Media Group",
number = "3",

}

TY - JOUR

T1 - The achievement of a 3-month complete cytogenetic response to second-generation tyrosine Kinase inhibitors predicts survival in patients with chronic phase chronic myeloid leukemia after imatinib failure

AU - Jabbour, Elias

AU - Kantarjian, Hagop

AU - Ghanem, Hady

AU - O'Brien, Susan

AU - Quintas-Cardama, Alfonso

AU - Garcia-Manero, Guillermo

AU - Cardenas, Marylou

AU - Cortes, Jorge

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Background: We assessed whether the achievement of a 3-month complete cytogenetic response (CCyR) in 123 patients with chronic myeloid leukemia (CML) in the chronic phase, which was treated with second-generation tyrosine kinase inhibitors (2nd-TKI) after imatinib failure could predict for survival. Patients and Methods: In a multivariate analysis, the lack of a 3-month CCyR to 2nd-TKI therapy was selected as the only independent factor associated with poor event-free survival (hazard ratio [HR] 4.5; P <.001) and overall survival (5.4; P =.03). Results: The 3-year event-free survival and overall survival rates were 74% and 43%, respectively, for patients with 3-month CCyR, and were 98% and 79%, respectively, for patients without 3-month CCyR. In a multivariate analysis, high hemoglobin level, previous major cytogenetic response to imatinib therapy, and ≤90% Philadelphia-positive metaphases were associated with the achievement of a 3-month CCyR. Conclusion: The achievement of a 3-month CCyR is the only predictor of outcome in patients treated with 2nd-TKI therapy after imatinib failure. Patients with <3-month CCyR may not obtain long-term benefit and should be followed-up closely.

AB - Background: We assessed whether the achievement of a 3-month complete cytogenetic response (CCyR) in 123 patients with chronic myeloid leukemia (CML) in the chronic phase, which was treated with second-generation tyrosine kinase inhibitors (2nd-TKI) after imatinib failure could predict for survival. Patients and Methods: In a multivariate analysis, the lack of a 3-month CCyR to 2nd-TKI therapy was selected as the only independent factor associated with poor event-free survival (hazard ratio [HR] 4.5; P <.001) and overall survival (5.4; P =.03). Results: The 3-year event-free survival and overall survival rates were 74% and 43%, respectively, for patients with 3-month CCyR, and were 98% and 79%, respectively, for patients without 3-month CCyR. In a multivariate analysis, high hemoglobin level, previous major cytogenetic response to imatinib therapy, and ≤90% Philadelphia-positive metaphases were associated with the achievement of a 3-month CCyR. Conclusion: The achievement of a 3-month CCyR is the only predictor of outcome in patients treated with 2nd-TKI therapy after imatinib failure. Patients with <3-month CCyR may not obtain long-term benefit and should be followed-up closely.

KW - Chronic myeloid leukemia

KW - Cytogenetic response

KW - Prognosis

KW - Tyrosine kinase inhibitor

UR - http://www.scopus.com/inward/record.url?scp=84877773183&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877773183&partnerID=8YFLogxK

U2 - 10.1016/j.clml.2012.12.005

DO - 10.1016/j.clml.2012.12.005

M3 - Article

C2 - 23318257

AN - SCOPUS:84877773183

VL - 13

SP - 302

EP - 306

JO - Clinical Lymphoma, Myeloma and Leukemia

JF - Clinical Lymphoma, Myeloma and Leukemia

SN - 2152-2650

IS - 3

ER -