TY - JOUR
T1 - The achievement of a 3-month complete cytogenetic response to second-generation tyrosine Kinase inhibitors predicts survival in patients with chronic phase chronic myeloid leukemia after imatinib failure
AU - Jabbour, Elias
AU - Kantarjian, Hagop
AU - Ghanem, Hady
AU - O'Brien, Susan
AU - Quintas-Cardama, Alfonso
AU - Garcia-Manero, Guillermo
AU - Cardenas, Marylou
AU - Cortes, Jorge
N1 - Funding Information:
E. Jabbour has received honoraria from BMS and Novartis. H. Kantarjian and J. Cortes received research grants from Novartis and BMS. The remaining authors have stated that they have no conflicts of interest.
PY - 2013/6
Y1 - 2013/6
N2 - Background: We assessed whether the achievement of a 3-month complete cytogenetic response (CCyR) in 123 patients with chronic myeloid leukemia (CML) in the chronic phase, which was treated with second-generation tyrosine kinase inhibitors (2nd-TKI) after imatinib failure could predict for survival. Patients and Methods: In a multivariate analysis, the lack of a 3-month CCyR to 2nd-TKI therapy was selected as the only independent factor associated with poor event-free survival (hazard ratio [HR] 4.5; P <.001) and overall survival (5.4; P =.03). Results: The 3-year event-free survival and overall survival rates were 74% and 43%, respectively, for patients with 3-month CCyR, and were 98% and 79%, respectively, for patients without 3-month CCyR. In a multivariate analysis, high hemoglobin level, previous major cytogenetic response to imatinib therapy, and ≤90% Philadelphia-positive metaphases were associated with the achievement of a 3-month CCyR. Conclusion: The achievement of a 3-month CCyR is the only predictor of outcome in patients treated with 2nd-TKI therapy after imatinib failure. Patients with <3-month CCyR may not obtain long-term benefit and should be followed-up closely.
AB - Background: We assessed whether the achievement of a 3-month complete cytogenetic response (CCyR) in 123 patients with chronic myeloid leukemia (CML) in the chronic phase, which was treated with second-generation tyrosine kinase inhibitors (2nd-TKI) after imatinib failure could predict for survival. Patients and Methods: In a multivariate analysis, the lack of a 3-month CCyR to 2nd-TKI therapy was selected as the only independent factor associated with poor event-free survival (hazard ratio [HR] 4.5; P <.001) and overall survival (5.4; P =.03). Results: The 3-year event-free survival and overall survival rates were 74% and 43%, respectively, for patients with 3-month CCyR, and were 98% and 79%, respectively, for patients without 3-month CCyR. In a multivariate analysis, high hemoglobin level, previous major cytogenetic response to imatinib therapy, and ≤90% Philadelphia-positive metaphases were associated with the achievement of a 3-month CCyR. Conclusion: The achievement of a 3-month CCyR is the only predictor of outcome in patients treated with 2nd-TKI therapy after imatinib failure. Patients with <3-month CCyR may not obtain long-term benefit and should be followed-up closely.
KW - Chronic myeloid leukemia
KW - Cytogenetic response
KW - Prognosis
KW - Tyrosine kinase inhibitor
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U2 - 10.1016/j.clml.2012.12.005
DO - 10.1016/j.clml.2012.12.005
M3 - Article
C2 - 23318257
AN - SCOPUS:84877773183
SN - 2152-2650
VL - 13
SP - 302
EP - 306
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 3
ER -