scholarly journals Analysis of Elderly Patients with Chronic Myeloid Leukemia

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5449-5449
Author(s):  
Engin Kelkitli ◽  
Hakan Goker ◽  
Mehmet Turgut ◽  
Memis Hilmi Atay

Abstract Aims We aimed to evaluate in clinical results >65 years with chronic myeloid leukemia (CML). Methods 191 CML patients treated with imatinib frontline were evaluated retrospectively. 56 patients who aged >65 years were included our study. The clinical characteristics and treatment outcomes of these patients were evaluated. Results A total of 56 patients (24 [57.1%] men, 32 [42.9%] women) were evaluated retrospectively. The median age of the patients was 72 years (range 66-92years). Of the patients, 56 (98.2%) were in the chronic phase and one (1.8%) were in the accelerated phase when diagnosed. All of patients (100%) were receiving imatinib as the first-line therapy. Imatinib treatment induced 51 (91.8%) complete hematological responses at 3 months, 29 (51.8 %) complete cytogenetic responses at 6 months and 37 (66.6%) major molecular responses at 12months. As a result, nilotinib and dasatinib were used in 28 (50%) patients as second-line therapy because of intolerance 5 (8.9%), primary and soconder unresponsiveness 14 (25%), 9 (16.1%) respectively. Second-line Tyrosine kinase inhibitors (TKI) induced 23 complete hematological responses (82.1%) at 3 months, and 20 major molecular responses (71.4%) at 12 months. Fifty-two of 56 patients (92.9%) are still alive. The 5 year median overall survival and progression free survival rates were 92% and 85% respectively. Conclusion The prognosis of CML patients has changed with Tyrosine kinase inhibitors (TKI). In our study, we found that the response rate and survival rates elderly patients were similar to the younger patients in the literature. Disclosures No relevant conflicts of interest to declare.

2013 ◽  
Vol 88 (12) ◽  
pp. 1024-1029 ◽  
Author(s):  
Lorenzo Falchi ◽  
Hagop M. Kantarjian ◽  
Xuemei Wang ◽  
Dushyant Verma ◽  
Alfonso Quintás-Cardama ◽  
...  

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17009-e17009
Author(s):  
Digisha Trivedi ◽  
Shahla Amin ◽  
Ling Zhu ◽  
Sam Joo ◽  
Hugh Kawabata ◽  
...  

e17009 Background: Some studies have demonstrated the correlation between adherence and persistence to therapy and the effectiveness of that therapy, thereby reinforcing the need to optimize both as a core treatment strategy. Because available data are limited, we examined real world adherence and persistence to the 2nd generation tyrosine kinase inhibitors (TKIs) used to treat chronic myeloid leukemia (CML). Methods: An observational retrospective study was conducted using pooled Invision Data Mart and Pharmetrics claims data. Adult CML patients with at least two prescriptions for a 2nd generation TKI between July 1, 2006 and December 31, 2010 were identified and followed for a maximum of 6 months from their index date (first observed prescription date). Dasatinib and nilotinib patients with prior imatinib use in 6 month pre-index period were classified as second-line and those with no prior use as first-line patients. Adherence to treatment was defined by the medication possession ratio (MPR) and persistence as the proportion of patients refilling prescriptions within 1.5 times the days supply during the follow-up period. Results: Of the 276 CML patients identified, 179 received dasatinib (n=50 first-line; n=129 second-line) and 97 received nilotinib (n=27 first-line; n=70 second-line). Patient characteristics were similar across treatment groups. Proportions with MPR ≥85% were 64% and 75% for first- and second-line dasatinib and 48% and 61% for first- and second-line nilotinib. Persistence rates were 36% and 47% for first- and second-line dasatinib and 26% and 39% for first- and second-line nilotinib. Conclusions: In both first- and second-line use, dasatinib was associated with higher adherence and persistence than the corresponding nilotinib-treated group. The reason for the difference between these TKIs is not known and will require further study.


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