Although long-term outcome of first-line imatinib is excellent, partially due to administration of other tyrosine kinase inhibitors (TKIs), all responses and outcomes are inferior in high-risk patients with chronic myeloid leukemia (CML), who require a specific risk-adapted treatment in order to optimize treatment results, according to an article published online ahead of print in Leukemia.

Imatinib has been the standard of care for patients with CML for the past decade. The introduction of other TKIs has created an intense debate: some studies have limited follow-up, are missing relevant data, or have protocol restrictions.

In this study, researchers aimed to provide a comprehensive, long-term analysis of patients treated with first-line imatinib.

A total of 559 newly diagnosed, chronic-phase patients treated with first-line therapy with imatinib were analyzed. 

With a minimum follow-up of 66 months 65% of patients continued on imatinib, 19% were on an alternative treatment, 12% had died, and 4% were lost to follow-up.

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Researchers confirmed the prognostic value of the BCR-ABL1 ratio at 3 months as well as the prognostic value of complete cytogenetic response and major molecular response at 1 year.

Overall survival at 6 years was 89%, but 50% occurred in remission; therefore the 6-year cumulative incidence of leukemia-related death was 5%.

Reference

  1. Catagnetti F, Gugliotta G, Brreccia M, et al. Long-term outcome of chronic myeloid leukemia patients treated frontline with imatinib. Leukemia. 2015. [epub ahead of print]. doi: 10.1038/leu.2015.152.