Long-term survival benefit and improved complete cytogenetic and molecular response rates with imatinib mesylate in Philadelphia chromosome-positive chronic-phase chronic myeloid leukemia after failure of interferon-α

被引:130
作者
Kantarjian, HM
Cortes, JE
O'Brien, S
Luthra, R
Giles, F
Verstovsek, S
Facerl, S
Thomas, D
Garcia-Manero, G
Rios, MB
Shan, J
Jones, D
Talpaz, M
机构
[1] Univ Texas, MD Anderson Canc Ctr, Dept Leukemia, Houston, TX 77030 USA
[2] Univ Texas, MD Anderson Canc Ctr, Dept Bioimmunotherapy, Houston, TX 77030 USA
[3] Univ Texas, MD Anderson Canc Ctr, Dept Hematopathol, Houston, TX 77030 USA
关键词
D O I
10.1182/blood-2004-02-0711
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We reviewed 261 patients with chronic-phase chronic myelogenous leukemia (CIVIL) after interferon-alpha (IFN-alpha) failure treated with imatinib mesylate 400 mg daily. With a median follow-up time of 45 months, the major cytogenetic response rate was 73% and the complete cytogenetic response rate 63%. The estimated 4-year survival rate was 86%. Multivariate analysis for survival identified hematologic resistance to IFN-alpha (P = .01), splenomegaly (P = .03), and lack of any cytogenetic response after 3 months of therapy (P = .01) to have independent poor prognostic significance. Patients could be divided into good- (no adverse factors), intermediate-(1 adverse factor), and poor-risk groups (2 or 3 adverse factors; 12% of patients) with estimated 4-year survival rates of 96%, 86%, and 49%, respectively (P < .00001). The 4-year cumulative major molecular response (quantitative reverse transcriptase-polymerase chain reaction [Q-PCR] = BCR-ABL/ABL less than 0.05%) rate was 43% and complete molecular response rate (BCR-ABL undetectable) 26%. Compared with a historical group of 251 similar patients treated with nonimatinib therapies, imatinib mesylate was associated with a better 4-year survival rate (86% versus 43%; P < .0001); the survival advantage was confirmed by multivariate analysis (hazard ratio, 0.19; P < .0001). (C) 2004 by The American Society of Hematology.
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页码:1979 / 1988
页数:10
相关论文
共 54 条
[1]  
Baccarani M, 1999, J CLIN ONCOL, V17, P1858
[2]  
BEATTY P, 1998, NEW ENGL J MED, V338, P962
[3]  
Beran M, 1998, CLIN CANCER RES, V4, P1661
[4]  
Bocchia M, 2003, BLOOD, V102, p30A
[5]   Chronic myeloid leukemia and interferon-α:: a study of complete cytogenetic responders [J].
Bonifazi, F ;
de Vivo, A ;
Rosti, G ;
Guilhot, F ;
Guilhot, J ;
Trabacchi, E ;
Hehlmann, R ;
Hochhaus, A ;
Shepherd, PCA ;
Steegmann, JL ;
Kluin-Nelemans, HC ;
Thaler, J ;
Simonsson, B ;
Louwagie, A ;
Reiffers, J ;
Mahon, FX ;
Montefusco, E ;
Alimena, G ;
Hasford, J ;
Richards, S ;
Saglio, G ;
Testoni, N ;
Martinelli, G ;
Tura, S ;
Baccarani, M .
BLOOD, 2001, 98 (10) :3074-3081
[6]  
*CHRON MYEL LEUK T, 2001, JNCI-J NATL CANCER I, V89, P1616
[7]   Effects of age on prognosis with imatinib mesylate therapy for patients with Philadelphia chromosome-positive chronic myelogenous leukemia [J].
Cortes, J ;
Talpaz, M ;
O'Brien, S ;
Giles, F ;
Rios, MB ;
Shan, JQ ;
Faderl, S ;
Garcia-Manero, G ;
Ferrajoli, A ;
Wierda, W ;
Kantarjian, H .
CANCER, 2003, 98 (06) :1105-1113
[8]   Prognostic significance of cytogenetic clonal evolution in patients with chronic myelogenous leukemia on imatinib mesylate therapy [J].
Cortes, JE ;
Talpaz, M ;
Giles, F ;
O'Brien, S ;
Rios, MB ;
Shan, J ;
Garcia-Manero, G ;
Faclerl, S ;
Thomas, DA ;
Wierda, W ;
Ferrajoli, A ;
Jeha, S ;
Kantarjian, HM .
BLOOD, 2003, 101 (10) :3794-3800
[9]  
COX DR, 1972, J R STAT SOC B, V34, P187
[10]   INDUCTION OF CHRONIC MYELOGENOUS LEUKEMIA IN MICE BY THE P210BCR/ABL GENE OF THE PHILADELPHIA-CHROMOSOME [J].
DALEY, GQ ;
VANETTEN, RA ;
BALTIMORE, D .
SCIENCE, 1990, 247 (4944) :824-830