Faculty Opinions recommendation of Favorable long-term follow-up results over 6 years for response, survival, and safety with imatinib mesylate therapy in chronic-phase chronic myeloid leukemia after failure of interferon-alpha treatment.

Author(s):  
Michael Deininger ◽  
Paul La Rosée
Cancer ◽  
2012 ◽  
Vol 118 (12) ◽  
pp. 3116-3122 ◽  
Author(s):  
Hagop Kantarjian ◽  
Susan O'Brien ◽  
Guillermo Garcia-Manero ◽  
Stefan Faderl ◽  
Farhad Ravandi ◽  
...  

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4268-4268
Author(s):  
Bjorn W. Hackanson ◽  
Cornelius F Waller

Abstract Abstract 4268 Before the introduction of imatinib mesylate, the median survival of chronic myeloid leukemia (CML) patients was approximately 60 months and the standard treatment with interferon-alpha (IFN-α) resulted in major cytogenetic responses of 20-25 %. As an alternative treatment approach at that time, intensive chemotherapy followed by autologous hematopoietic stem cell transplantation (autoHSCT) was investigated with the rational of debulking disease burden and mobilisation and transplantation of Philadelphia chromosome-negative (Ph-) stem cells. In the era of tyrosine kinase inhibitors (TKIs) as state-of-the-art therapy for CML, the concept of autoHSCT has attracted only little interest and long-term follow-up and outcome data after autoHSCT in CML patients is scarce. In this long-term analysis, we report on 21 CML patients, mobilized in early chronic phase (ECP) and transplanted with largely Ph- grafts, who received interferon alpha (IFNα) as maintenance. Imatinib mesylate was given upon cytogenetic relapse or disease progression after IFN-α. The 10-year survival was 61% and 11 patients (52%) were alive at a median follow-up of 12.5 years (range 0.3 - 13.8) with 8 patients in complete hematologic remission (CHR) and 3 of 8 in major molecular remission (MMR). While all patients in MMR and 2 of 5 patients in CHR received imatinib, it is noteworthy that three patients remaining in CHR only received IFN-α maintenance after autoHSCT. With the limitations of a small patient population, this is the longest follow-up analysis demonstrating that autoHSCT in CML is very efficient to debulk the disease and able to induce major and sustained molecular responses in the majority of patients with substantial long-term survival rates. Disclosures: Waller: Hospira UK Ltd: Consultancy.


2015 ◽  
Vol 90 (5) ◽  
pp. E95-E96
Author(s):  
Massimo Breccia ◽  
Roberto Latagliata ◽  
Matteo Molica ◽  
Gioia Colafigli ◽  
Marco Mancini ◽  
...  

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4529-4529
Author(s):  
Jun Wang ◽  
Aining Sun ◽  
Wu Depei ◽  
Huiying Qiu ◽  
XiaoWen Tang

Abstract Abstract 4529 Objective: To observe the efficacy and safety of imatinib mesylate (IM) accompany with allogeneic transplantation for chronic myeloid leukemia (CML). Methods: During the period from January 2003 to August 2011,we retrospectively observed 95 patients with CML receiving IM for a minimum of 4 months before allogeneic hematopoietic stem cell transplantation (HSCT). Patients with advanced CML received IM from 3 month after transplantation for 12 months. Results: Among 95 enrolled patients (CML-CP 76, CML-AP 10, CML-BP 9), types of transplantation: sib-matched HSCT 64, unrelated-HSCT 19, haplo-HSCT 12. For the whole patients, 7 year overall survival (OS) is 80.5%, and disease free survival (DFS) is 74.5%. Complete hematologic response (CHR) is 93.6%, complete cytogenetic response (CCR) is 84.5%, major cytogenetic response (MCR) is 60.3% at 7 year. For CML-CP1, OS is 83.2% and CML-AP/BC is 33.3% (P<0.05). Compared patients of advanced CML achieving CP2 after IM and with no CP2,the former has better results of CCR or MCR, OS and PFS (P<0.05). The total treatment related mortality (TRM) is 16.8%. Cox multivariate regression analysis of prognostic factors indicates that status of CML and severe acute graft-versus-host disease (aGVHD III-‡W) retain independent predictive value. No increase in rates of serious adverse events was observed with continuous use of IM for up to 7 years. Conclusions: For chronic myeloid leukemia, combining with imatinib mesylate and allogeneic transplantation is a good strategy, with favorable long-term follow-up results and acceptable TRM, especially for the patients with advanced CML. Disclosures: No relevant conflicts of interest to declare.


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