Imatinib for Newly Diagnosed Patients With Chronic Myeloid Leukemia: Incidence of Sustained Responses in an Intention-to-Treat Analysis

作者：Hugues de Lavallade, Jane F. Apperley, Jamshid Sorouri Khorashad, Dragana Milojković, Alistair G. Reid, Marco Bua, Richard Szydlo, Eduardo Olavarría, Jaspal Kaeda, John M. Goldman, David Marín · 发表于：Journal of Clinical Oncology · 年份：2008 · DOI：10.1200/jco.2007.15.8154 · 被引用次数：557 · 研究领域：Chronic Myeloid Leukemia Treatments、Eosinophilic Disorders and Syndromes、Myeloproliferative Neoplasms: Diagnosis and Treatment

PURPOSE: Imatinib is remarkably effective in treating newly diagnosed patients with chronic myeloid leukemia (CML) in chronic phase (CP). To date, most of the available data come from a single multicenter study in which some of the patients were censored for diverse reasons. Here, we report our experience in treating patients at a single institution in a setting where all events were recorded. PATIENTS AND METHODS: A total of 204 consecutive adult patients with newly diagnosed CML in CP received imatinib from June 2000 until August 2006. Response (hematologic, cytogenetic, and molecular), progression-free survival (PFS) and survival were evaluated. RESULTS: At 5 years, cumulative incidences of complete cytogenetic response (CCyR) and major molecular response (MMR) were 82.7% and 50.1%, respectively. Estimated overall survival and PFS were 83.2% and 82.7%, respectively. By 5 years, 25% of patients had discontinued imatinib treatment because of an unsatisfactory response and/or toxicity. The 5-year probability of remaining in major cytogenetic response while still receiving imatinib was 62.7%. Patients achieving a CCyR at 1 year had a better PFS and overall survival than those failing to reach CCyR, but achieving a MMR conferred no further advantage. The identification of a kinase domain mutation was the only factor predicting for loss of CCyR. CONCLUSION: Imatinib is highly effective in most patients with CML-CP; patients who respond are likely to live substantially longer tha...