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CML in Elderly: Does Age Matter?

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Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

The median age of diagnosis for chronic myeloid leukemia (CML) in India is 35 years on the contrary to western literature which is 47 years. The outcome of the elderly patient in CML TKI era is not reported from the Indian population. However, Western literature suggests that use of TKI alleviate the adverse impact of age in outcomes of CML. This study was carried out to analyze the clinical profile and outcome of elderly, in comparison with younger patients with CML. We retrospectively analyzed CML patients treated at our department from January 2008 to December 2017. The data cutoff date was December 2018. The cohorts of 712 patients were divided into two groups. Patients belonging to the age group of ≥ 60 years were classified as the study group and those who were 18–60 years were used as controls. Patient’s clinical history, examination and milestones in terms of achieving hematological, molecular responses and toxicity profile were also recorded. The total of 712 patients, 52 patients in the study group and 660 patients in the control group were treated during the study period. The study group was having more co-morbidities than the control group (15.3% vs. 4.5%). Patients having high-risk EUTOS score were similar in both groups (38.4% vs. 37.6%). The patients presented in blast phase were higher in the study group as compared to control group (9.6% vs. 6.36%) but the differences were not statistically significant. Rates of achieving a hematological response at 3 months (85.1% vs. 86.89%) and the major molecular response at 18 months (54.3% vs. 60.16%) were almost similar in both groups. However, hematological toxicity, muscle cramps and gastritis were reported more in elderly patients. The outcome of CML patients in TKI era do not differ in elderly patients. However, toxicity profile was not significantly inferior in elderly patients.

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References

  1. Mishra P, Seth T, Mahapatra M et al (2013) Report of chronic myeloid leukemia in chronic phase from All India Institute of Medical Sciences, 1990–2010. Indian J Med Paediatr Oncol 34:159–163

    Article  Google Scholar 

  2. Sokal JE, Cox EB, Baccarani M, Tura S, Gomez GA, Robertson JE et al (1984) Prognostic discrimination in “good-risk” chronic granulocytic leukemia. Blood 63:789–799

    Article  CAS  Google Scholar 

  3. Hasford J, Pfirrmann M, Hehlmann R, Allan NC, Baccarani M, Kluin-Nelemans JC et al (1998) A new prognostic score for survival of patients with chronic myeloid leukemia treated with interferon alfa. J Natl Cancer Inst 90:850–858

    Article  CAS  Google Scholar 

  4. Berger U, Engelich G, Maywald O et al (2003) Chronic myeloid leukemia in the elderly: long-term results from randomized trials with interferon alpha. Leukemia 17(9):1820–1826

    Article  CAS  Google Scholar 

  5. Woessner DW, Lim CS, Deininger MW et al (2011) Development of an effective therapy for chronic myelogenous leukemia. Cancer J (Sudbury, MA.) 17(6):477–486

    Article  CAS  Google Scholar 

  6. Bali AM (2017) Population ageing in India. Can Stud Popul 43:299. https://doi.org/10.25336/P61G7S

    Article  Google Scholar 

  7. Balducci L, Dolan D (2014) Chronic myelogenous leukemia (CML) in the elderly. Mediterr J Hematol Infect Dis 6(1):e2014037

    Article  Google Scholar 

  8. Costes J, Talpaz M, O’Brien S et al (2003) Effects of age on prognosis with imatinib mesylate therapy in patients with Philadelphia chromosome positive chronic myelogenous leukemia. Cancer 98:1105–1113

    Article  Google Scholar 

  9. Hochhaus A (2011) Educational session: managing chronic myeloid leukemia as a chronic disease. Hematol Am Soc Hematol Educ Program 2011:128–135. https://doi.org/10.1182/asheducation-2011.1.128

    Article  Google Scholar 

  10. Rosti G, Iacobucci I, Bassi S et al (2007) Impact of age on the outcome of patients with chronic myeloid leukemia in late chronic phase: results of a phase II study of the GIMEMA CML Working Party. Haematologica 92:101–105

    Article  Google Scholar 

  11. Brunner AM, Campigotto F, Sadrzadeh H et al (2013) Trends in all cause mortality among patients with chronic myeloid leukemia: a Surveillance Epidemiology and End Results Data base analysis. Cancer 119:2620–2629

    Article  Google Scholar 

  12. Bjorkholm M, Ohm L, Eloranta S et al (2011) Success story of targeted therapy in Chronic Myeloid leukemia: a population based study of patients diagnosed in Sweden from 1973 to 2008. J Clin Oncol 29:2514–2520

    Article  Google Scholar 

  13. Latagliata R, Ferrero D, Iurlo A et al (2013) Imatinib in very elderly patients with chronic myeloid leukemia in chronic stage: a retrospective study. Drugs Aging 30:629–637

    Article  CAS  Google Scholar 

  14. Sheehy OM, Irvine AE, Cuthbert RJ, Humphreys MW, McMullin MF (2008) Use of imatinib mesylate in elderly patients in Northern Ireland: evidence of comparable haematological and molecular responses to younger patients. Hematology 13(3):133–136

    Article  CAS  Google Scholar 

  15. Kantarjian H, Smith TL, McCredie K et al (1985) Chronic myelogenous leukemia: a multivariate analysis of the associations of patients’ characteristics and therapy with survival. Blood 66(6):1366–1375

    Article  Google Scholar 

  16. Breccia M, Tiribelli M, Alimena G et al (2012) Tyrosine kinase inhibitors for elderly chronic myeloid leukemia patients: a systematic review of efficacy and safety data. Crit Rev Oncol Hematol 84(1):93–100

    Article  Google Scholar 

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Correspondence to Jitendra Kumar Pehalajani.

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Lokesh, K.N., Pehalajani, J.K., Loknatha, D. et al. CML in Elderly: Does Age Matter?. Indian J Hematol Blood Transfus 36, 47–50 (2020). https://doi.org/10.1007/s12288-019-01143-4

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  • DOI: https://doi.org/10.1007/s12288-019-01143-4

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