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Imatinib in the first-line treatment of chronic myelogenous leukemia in chronic phase


Authors: J. Mayer 1;  H. Klamová 2;  D. Žáčková 1;  P. Cetkovský 2;  M. Doubek 1;  J. Moravcová 2;  J. Rulcová 2;  K. Machová 2;  D. Dvořáková 1;  T. Jurček 1;  J. Březinová 2;  K. Michalová 2,3;  Z. Zemanová 3;  A. Oltová 4
Authors‘ workplace: Interní hematoonkologická klinika FN a LF Masarykovy univerzity, Brno, 2Ústav hematologie a krevní transfuze, Praha, 3Centrum nádorové cytogenetiky ÚKBLD VFN a 1. LF UK, Praha, 4Oddělení lékařské genetiky FN, Brno, Česká leukemická skupina – pro život (Th 1
Published in: Transfuze Hematol. dnes,14, 2008, No. 4, p. 150-158.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

Imatinib has changed the paradigm of chronic myelogenous leukemia (CML) treatment. Moving imatinib into the first-line CML therapy is based predominantly on excellent results of IRIS trial. Population-based real-life data, however, are still scarce. The aim of the study was to describe the efficacy and toxicity of imatinib in the first-line setting on an unselected population of CML patients. Data about CML patients in the first chronic phase who were treated with imatinib were prospectively collected into the database called INFINITY. One of the main goals was to include all consecutive patients treated in two large hematooncological centers in Prague and Brno. 105 patients (pts) have been included (51 males and 54 females) aged 54 years (median; 20–77). Median follow-up at the date of the analysis was 16 months (0.3–50). The median actually administered imatinib dose was 400 mg. After 12 months of therapy, the response rates were: complete hematological response 94 %, complete cytogenetic response 70 %, partial cytogenetic response 14 % and major molecular response 42 % with 4 % of complete molecular responses; at twelve months Bcr-Abl expression was 0.15 % (median; 0 %–31 %). In total, 15 patients stopped the treatment for various reasons: 5 pts underwent allogeneic hematopoietic stem cell transplantation, 7 pts changed the tyrosine kinase inhibitor for imatinib failure (dasatinib, n = 6; nilotinib, n = 1), and 3 patients were switched to dasatinib for intolerable non-hematological toxicity. There was only one death, however, linked to the alcohol intoxication.

Key words:
chronic myelogenous leukemia, imatinib, treatment


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