Frontline imatinib treatment of chronic myeloid leukemia: no impact of age on outcome, a survey by the GIMEMA CML Working Party
Gabriele Gugliotta, Fausto Castagnetti, Francesca Palandri, Massimo Breccia, Tamara Intermesoli, Adele Capucci, Bruno Martino, Patrizia Pregno, Serena Rupoli, Dario Ferrero, Filippo Gherlinzoni, Enrico Montefusco, Monica Bocchia, Mario Tiribelli, Ivana Pierri, Federica Grifoni, Giulia Marzocchi, Marilina Amabile, Nicoletta Testoni, Giovanni Martinelli, Giuliana Alimena, Fabrizio Pane, Giuseppe Saglio, Michele Baccarani, Gianantonio Rosti, Gruppo Italiano Malattie Ematologiche dell'Adulto CML Working Party, Gabriele Gugliotta, Fausto Castagnetti, Francesca Palandri, Massimo Breccia, Tamara Intermesoli, Adele Capucci, Bruno Martino, Patrizia Pregno, Serena Rupoli, Dario Ferrero, Filippo Gherlinzoni, Enrico Montefusco, Monica Bocchia, Mario Tiribelli, Ivana Pierri, Federica Grifoni, Giulia Marzocchi, Marilina Amabile, Nicoletta Testoni, Giovanni Martinelli, Giuliana Alimena, Fabrizio Pane, Giuseppe Saglio, Michele Baccarani, Gianantonio Rosti, Gruppo Italiano Malattie Ematologiche dell'Adulto CML Working Party
Abstract
The median age of chronic myeloid leukemia (CML) patients is ~60 years, and age is still considered an important prognostic factor, included in Sokal and EURO risk scores. However, few data are available about the long-term outcome of older patients treated with imatinib (IM) frontline. We analyzed the relationship between age and outcome in 559 early chronic-phase CML patients enrolled in 3 prospective clinical trials of Gruppo Italiano Malattie Ematologiche dell'Adulto CML Working Party, treated frontline with IM, with a median follow-up of 60 months. There were 115 older patients (≥ 65 years; 21%). The complete cytogenetic and major molecular response rates were similar in the 2 age groups. In older patients, event-free survival (55% vs 67%), failure-free survival (78% vs 92%), progression-free survival (62% vs 78%), and overall survival (75% vs 89%) were significantly inferior (all P < .01) because of a higher proportion of deaths that occurred in complete hematologic response, therefore unrelated to CML progression (15% vs 3%, P < .0001). The outcome was similar once those deaths were censored. These data show that response to IM was not affected by age and that the mortality rate linked to CML is similar in both age groups. This trial was registered at www.clinicaltrials.gov as #NCT00514488 and #NCT00510926.
Source: PubMed