Prediction of outcomes in patients with Ph+ chronic myeloid leukemia in chronic phase treated with nilotinib after imatinib resistance/intolerance

  • E. Jabbour
  • , P. D. Le Coutre
  • , J. Cortes
  • , F. Giles
  • , K. N. Bhalla
  • , J. Pinilla-Ibarz
  • , R. A. Larson
  • , N. Gattermann
  • , O. G. Ottmann
  • , A. Hochhaus
  • , T. P. Hughes
  • , G. Saglio
  • , J. P. Radich
  • , D. W. Kim
  • , G. Martinelli
  • , J. Reynolds
  • , R. C. Woodman
  • , M. Baccarani
  • , H. M. Kantarjian

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

The purpose was to assess predictive factors for outcome in patients with chronic myeloid leukemia (CML) in chronic phase (CML-CP) treated with nilotinib after imatinib failure. Imatinib-resistant and-intolerant patients with CML-CP (n=321) were treated with nilotinib 400 mg twice daily. Of 19 baseline patient and disease characteristics and two response end points analyzed, 10 independent prognostic factors were associated with progression-free survival (PFS). In the multivariate analysis, major cytogenetic response (MCyR) within 12 months, baseline hemoglobin ≥120 g/l, baseline basophils <4%, and absence of baseline mutations with low sensitivity to nilotinib were associated with PFS. A prognostic score was created to stratify patients into five groups (best group: 0 of 3 unfavorable risk factors and MCyR by 12 months; worst group: 3 of 3 unfavorable risk factors and no MCyR by 12 months). Estimated 24-month PFS rates were 90%, 79%, 67% and 37% for patients with prognostic scores of 0, 1, 2 and 3, respectively, (no patients with score of 4). Even in the presence of poor disease characteristics, nilotinib provided significant clinical benefit in patients with imatinib-resistant or-intolerant CML. This system may yield insight on the prognosis of patients.

Original languageEnglish (US)
Pages (from-to)907-913
Number of pages7
JournalLeukemia
Volume27
Issue number4
DOIs
StatePublished - Apr 2013
Externally publishedYes

Keywords

  • chronic myeloid leukemia
  • imatinib intolerance
  • imatinib resistance
  • multivariate analysis
  • nilotinib
  • predictive model

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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