TY - JOUR
T1 - Tyrosine kinase inhibitors as initial therapy for patients with chronic myeloid Leukemia in accelerated phase
AU - Ohanian, Maro
AU - Kantarjian, Hagop M.
AU - Quintas-Cardama, Alfonso
AU - Jabbour, Elias
AU - Abruzzo, Lynne
AU - Verstovsek, Srdan
AU - Borthakur, Gautam
AU - Ravandi, Farhad
AU - Garcia-Manero, Guillermo
AU - Champlin, Richard
AU - Pierce, Sherry
AU - Alattar, Mona Lisa
AU - Trinh, Long Xuan
AU - Luthra, Raja
AU - Ferrajoli, Alessandra
AU - Kadia, Tapan
AU - O'brien, Susan
AU - Cortes, Jorge E.
N1 - Funding Information:
This study was supported in part by the M.D. Anderson Cancer Center Support Grant CA016672 , and Award Number P01 CA049639 from the National Cancer Institute.
PY - 2014/4
Y1 - 2014/4
N2 - Background Accelerated phase CML most frequently represents a progression state in CML. However, some patients present with AP features at the time of diagnosis. There is limited information on the outcome of these patients who received TKIs as initial therapy. Patients and Methods We analyzed the outcome of 51 consecutive patients with CML who presented with features of AP at the time of diagnosis, including blasts ≥ 15% (n = 6), basophils ≥ 20% (n = 22), platelets < 100 × 109/L (n = 3), cytogenetic clonal evolution (n = 17), or more than 1 feature (n = 3). Patients received initial therapy with imatinib (n = 30), dasatinib (n = 5), or nilotinib (n = 16). Results The rate of complete cytogenetic response for patients treated with imatinib was 80%, and with dasatinib or nilotinib was 90%. Major molecular response (MMR) (Breakpoint Cluster Region (BCR)-Abelson (ABL)/ABL ≤ 0.1%, International Scale [IS]) was achieved in 69% of patients including complete molecular response (BCR-ABL/ABL ≤ 0.0032% IS) in 49%. MMR rates for patients treated with imatinib were 63%, and with 2GTKIs, 76%. Overall survival at 36 months was 87% with imatinib and 95% with 2GTKIs. Conclusion TKIs should be considered standard initial therapy for patients with AP at the time of diagnosis.
AB - Background Accelerated phase CML most frequently represents a progression state in CML. However, some patients present with AP features at the time of diagnosis. There is limited information on the outcome of these patients who received TKIs as initial therapy. Patients and Methods We analyzed the outcome of 51 consecutive patients with CML who presented with features of AP at the time of diagnosis, including blasts ≥ 15% (n = 6), basophils ≥ 20% (n = 22), platelets < 100 × 109/L (n = 3), cytogenetic clonal evolution (n = 17), or more than 1 feature (n = 3). Patients received initial therapy with imatinib (n = 30), dasatinib (n = 5), or nilotinib (n = 16). Results The rate of complete cytogenetic response for patients treated with imatinib was 80%, and with dasatinib or nilotinib was 90%. Major molecular response (MMR) (Breakpoint Cluster Region (BCR)-Abelson (ABL)/ABL ≤ 0.1%, International Scale [IS]) was achieved in 69% of patients including complete molecular response (BCR-ABL/ABL ≤ 0.0032% IS) in 49%. MMR rates for patients treated with imatinib were 63%, and with 2GTKIs, 76%. Overall survival at 36 months was 87% with imatinib and 95% with 2GTKIs. Conclusion TKIs should be considered standard initial therapy for patients with AP at the time of diagnosis.
KW - Accelerated phase CML (CML-AP)
KW - Complete cytogenetic response (CCyR)
KW - Major molecular response (MMR)
KW - Second generation TKI (2GTKIs)
KW - Tyrosine kinase inhibitors (TKI)
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U2 - 10.1016/j.clml.2013.08.008
DO - 10.1016/j.clml.2013.08.008
M3 - Article
C2 - 24332214
AN - SCOPUS:84896405273
SN - 2152-2650
VL - 14
SP - 155-162.E1
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 2
ER -
