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Impact of age on the clinical response of patients with CML treated with imatinib


Authors: Petra Bělohlávková;  Jaroslava Voglová;  Jakub Radocha;  Pavel Žák
Authors‘ workplace: IV. interní hematologická klinika LF UK a FN Hradec Králové, přednosta doc. MUDr. Pavel Žák, Ph. D.
Published in: Vnitř Lék 2015; 61(9): 785-791
Category: Original Contributions

Overview

Introduction:
Treatment of chronic myeloid leukemia (CML) with tyrosine kinase inhibitors (TKI) has significantly changed the survival of patients of all age categories. In our work, we have tried retrospectively to analyze a therapeutic response and toxicity of imatinib according to age of patients (≤ 60 years vs > 60 years). Patients have started treatment with imatinib in 2001–2013 in our department. The duration of treatment was at least 18 months.

Patients and methods:
The whole group contains 103 patients (52 women, 51 men) with a median age at diagnosis of CML 55 years (range 19–88 years). The first group includes 68 the younger patients (31 women, 37 men) with a median age at diagnosis 43 years (range 19–59 years) and the second group 35 the elderly patients (21 women, 14 men) with a median age at diagnosis 70 years (range 61–86 years). Median imatinib dose in both groups was the same – 400 mg per day (range 200–600 mg).

Results:
In the elderly patients we observed higher rates of hematological toxicities (p = 0.0059). After 12 months treatment, a complete cytogenetic response (CCyR) was achieved in 90 % of younger patients and in 74 % of the elderly patients, respectively. Major molecular response (MMR) at 18 months treatment was achieved in 79 % of the younger group and in 63 % of the elderly group.

Conclusion:
The results represent in both groups very good therapeutic response independent of age of patients at the time of CML diagnosis.

Key words:
age – chronic myeloid leukemia – imatinib – therapy


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