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Seven-year response to imatinib as initial treatment versus re-treatment in Chinese patients with chronic myelogenous leukemia in the chronic phase

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Abstract

The purpose of our study is to compare the 7-year response to imatinib monotherapy as an initial treatment and re-treatment in Chinese patients with chronic myelogenous leukemia-chronic phase (CML-CP) patients in a single center in Beijing. A retrospective study of 171 CML-CP patients receiving imatinib monotherapy was done with 73 in the initial treatment group (disease course ≤6 months) and 98 in the re-treatment group (disease course >6 months). Cumulative rates of complete cytogenetic response (CCyR) at 6, 12, and 36 months after imatinib treatment in the initial and re-treatment groups were 75%, 89%, and 96%, and 48%, 77% and 84% (p = 0.0002), respectively. The median time to CCyR in the initial and re-treatment groups was 6 months (95% CI, 3.3–8.3) and 9 months (95% CI, 6.4–11.6), respectively (p = 0.0002). Cumulative rates of major molecular responses at 9, 12, and 18 months after imatinib treatment in the initial and re-treatment groups were 31%, 48%, and 60%, and 15%, 25% and 37% (p = 0.017), respectively. The median time to the major molecular response in the initial and re-treatment groups was 15 months (95% CI, 12.3–17.7) and 36 months (95% CI, 25.9–46.0), respectively (p = 0.017). Progression-free survival at 84 months in the initial and re-treatment groups was 97% and 85%, respectively (p = 0.09). Event-free survival at 84 months in the initial and re-treatment groups was 92% and 70%, respectively (p = 0.049). Only two of the 171 patients discontinued imatinib therapy for grade 3/4 adverse events. Our study revealed that CML-CP patients would benefit from early treatment with imatinib.

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References

  1. Goldman JM, Melo JV (2003) Chronic myeloid leukemia: advances in biology and new approaches to treatment. N Engl J Med 349:1451–1464

    Article  CAS  PubMed  Google Scholar 

  2. Druker BJ, Lydon NB (2000) Lessons learned from the development of an Abl tyrosine kinase inhibitor for chronic myelogenous leukemia. J Clin Invest 105:3–7

    Article  CAS  PubMed  Google Scholar 

  3. Hochhaus A, Druker BJ, Sawyers C, Guilhot F, Schiffer CA, Cortes J et al (2008) Favorable long-term follow-up results over 6 years for response, survival, and safety with imatinib mesylate therapy in chronic-phase chronic myeloid leukemia after failure of interferon-treatment. Blood 111(3):1039–1043

    Article  CAS  PubMed  Google Scholar 

  4. Druker BJ, Guilhot F, O’Brien SG, Gathmann I, Kantarjian H, Gattermann N et al (2006) Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. N Engl J Med 355:2408–2417

    Article  CAS  PubMed  Google Scholar 

  5. Druker BJ, Talpaz M, Resta DJ, Peng B, Buchdunger E, Ford JM et al (2001) Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. N Engl J Med 344:1031–1037

    Article  CAS  PubMed  Google Scholar 

  6. Sawyers CL, Hochhaus A, Feldman E, Goldman JM, Miller CB, Ottmann OG et al (2002) Imatinib induces hematologic and cytogenetic responses in patients with chronic myelogenous leukemia in myeloid blast crisis: results of a phase II study. Blood 99:3530–3539

    Article  CAS  PubMed  Google Scholar 

  7. Talpaz M, Silver RT, Druker BJ, Goldman JM, Gambacorti-Passerini C, Guilhot F et al (2002) Imatinib induces durable hematologic and cytogenetic responses in patients with accelerated phase chronic myeloid leukemia: results of a phase 2 study. Blood 99:1928–1937

    Article  CAS  PubMed  Google Scholar 

  8. Kantarjian H, Sawyers C, Hochhaus A, Guilhot F, Schiffer C, Gambacorti-Passerini C et al (2002) Hematologic and cytogenetic responses to imatinib mesylate in chronic myelogenous leukemia. N Engl J Med 346:645–652

    Article  CAS  PubMed  Google Scholar 

  9. O’Brien SG, Guilhot F, Larson RA, Gathmann I, Baccarani M, Cervantes F et al (2003) Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med 348:994–1004

    Article  PubMed  Google Scholar 

  10. Jiang H, Chen S, Jiang B, Jiang Q, Lu D et al (2003) Imatinib in the treatment of 54 cases of Ph-positive chronic myeloid leukemia. Chin J Hematol 24:281–285

    Google Scholar 

  11. NCCN Practice Guidelines in Oncology-v.3.2008. http://www.nccn.org/professionals/physician_gls/PDF/cml.pdf

  12. Hong H, Qiu J, Lai Y, Shi Y, He Q, Dang H et al (2003) Cytogenetic analysis of interferon-α in the treatment of Ph+ chronic myeloid leukemia. Chin J Exp Hematol 3:269–273

    Google Scholar 

  13. Qin Y, Li J, Zhu H, Ruan G, Li L, Zhang Y et al (2006) The level of bcr-abl mRNA monitored by real-time quantitative RT-PCR in patients with chronic myeloid leukemia after hematopoietic stem cell transplantation. Chin J Hematol 8:511–514

    Google Scholar 

  14. O’Brien SG (2004) Optimal therapy in CML. Am Soc Hematol Educ Program 146–149

  15. Apperley JF (2003) Managing CML with patient-specific strategies. Am Soc Hematol Educ Program 142–152

  16. Shah NP (2005) Loss of response to imatinib: mechanisms and management. Am Soc Hematol Educ Program 183–187

  17. Hochhaus A, Druker BJ, Larson RA, O’Brien SG, Gathmann I, Guilhot F et al (2007) IRIS 6-year follow-up: sustained survival and declining annual rate of transformation in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP) treated with imatinib. Blood (ASH Annual Meeting Abstracts) 110(11) (abstr 25)

  18. Goldman JM, Hughes T, Radichet J, Branford S, Hochhaus A, So C et al (2005) Continuing reduction in level of residual disease after 4 years in patients with CML in chronic phase responding to first-line imatinib (IM) in the IRIS Study. Blood (ASH Annual Meeting Abstracts) 106(11) (abstr 163)

  19. Bonifazi F, de Vivo A, Rosti G, Guilhot F, Guilhot J, Trabacchi E et al (2001) Chronic myeloid leukemia and interferon-alpha: a study of complete cytogenetic responders. Blood 98:3074–3081

    Article  CAS  PubMed  Google Scholar 

  20. Kantarjian HM, O’Brien S, Cortes JE, Shan JQ, Giles FJ, Rios MB et al (2003) Complete cytogenetic and molecular responses to interferon-alpha-based therapy for chronic myelogenous leukemia are associated with excellent long-term prognosis. Cancer 97:1033–1041

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank the contributions of all the people who have participated in this research. This includes our laboratory staff, our colleagues, and our nurses. During April 2001 to April 2002, 46 patients in our study had enrolled in the international phase II expanded clinical trial of imatinib mesylate sponsored by Novartis. Imatinib for patients for 9 months every year was supplied by the Glivec International Patient Assistance Program (Novartis)—patients paid for the other 3 months each year themselves.

Funding

Supported by the program for innovative research team in the university (grant No. IRT 0702)

Authorship and Disclosures

JH, CSS, JB, and JQ received research grants from Novartis in the course of the international phase II expanded clinical trial of imatinib mesylate in China from April 2001 to April 2002. All other authors declare no competing financial interests. HXJ takes responsibility for the paper. JH, CSS, JB, and JQ recruited the patients. QYZ and LYY performed the laboratory work for this study. HXJ and JH coordinated the research. JH participated in the statistical analysis. HXJ and JH wrote the paper.

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Correspondence to Xiao-Jun Huang.

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Jiang, H., Chen, SS., Jiang, B. et al. Seven-year response to imatinib as initial treatment versus re-treatment in Chinese patients with chronic myelogenous leukemia in the chronic phase. Ann Hematol 90, 41–46 (2011). https://doi.org/10.1007/s00277-010-1031-0

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  • DOI: https://doi.org/10.1007/s00277-010-1031-0

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