Response and resistance in 300 patients with BCR‐ABL–positive leukemias treated with imatinib in a single center
Open Access
- 3 March 2005
- Vol. 103 (8) , 1659-1669
- https://doi.org/10.1002/cncr.20922
Abstract
BACKGROUND The advent of imatinib has considerably changed the treatment of chronic myeloid leukemia (CML). Early studies demonstrated high rates of hematologic and cytogenetic responses in all phases of the disease after limited observation periods. METHODS The authors evaluated long‐term outcome, rates of response, and resistance in 300 patients with BCR‐ABL–positive leukemias (CML in chronic phase after failure to respond to interferon‐alpha [CP], n = 139; accelerated phase [AP], n = 80; myeloid blast crisis [BC], n = 76; lymphoid BC and Philadelphia chromosome‐positive acute lymphoblastic leukemia, n = 5) who entered clinical trials with imatinib in a single center after an observation time of 4.5 years. RESULTS In CP, hematologic remission was achieved in 97% and major (MCR) and complete cytogenetic remission (CCR) in 61% and 49% of patients, respectively. The chance to achieve MCR was higher in patients commencing imatinib earlier in the course of CML. In AP, the median survival period after the start of imatinib was 44 months, and MCR and CCR were observed in 31% and 26% of patients, respectively. In myeloid BC, the median survival period after the start of imatinib and after diagnosis of BC was 6 and 9 months, respectively. Hematologic resistance occurred in 25%, 41%, and 92% of patients in CP, AP, and myeloid BC, respectively, and was associated with BCR‐ABL mutations in 45% of patients and with clonal evolution in 58% of patients. CONCLUSIONS The data emphasized the need for a prolonged follow‐up of patients treated with imatinib to define the clinical potential of the drug and to establish methods to optimize therapy. Cancer 2005. © 2005 American Cancer Society.Keywords
Funding Information
- Novartis Pharma, Nürnberg, Germany
- German Bundesministerium für Bildung und Forschung (DLR e.V.-01 GI9980/6)
- European LeukemiaNet
This publication has 31 references indexed in Scilit:
- Imatinib therapy in chronic myelogenous leukemia: strategies to avoid and overcome resistanceLeukemia, 2004
- Molecular monitoring of response to imatinib (Glivec®) in CML patients pretreated with interferon alpha. Low levels of residual disease are associated with continuous remissionLeukemia, 2003
- Molecular and chromosomal mechanisms of resistance to imatinib (STI571) therapyLeukemia, 2002
- Early reduction of BCR-ABL mRNA transcript levels predicts cytogenetic response in chronic phase CML patients treated with imatinib after failure of interferon αLeukemia, 2002
- A phase 2 study of imatinib in patients with relapsed or refractory Philadelphia chromosome-positive acute lymphoid leukemiasBlood, 2002
- Imatinib induces hematologic and cytogenetic responses in patients with chronic myelogenous leukemia in myeloid blast crisis: results of a phase II studyBlood, 2002
- Imatinib induces durable hematologic and cytogenetic responses in patients with accelerated phase chronic myeloid leukemia: results of a phase 2 studyBlood, 2002
- Hematologic and Cytogenetic Responses to Imatinib Mesylate in Chronic Myelogenous LeukemiaNew England Journal of Medicine, 2002
- Comparison of chromosome banding analysis, interphase- and hypermetaphase-FISH, qualitative and quantitative PCR for diagnosis and for follow-up in chronic myeloid leukemia: a study on 350 casesLeukemia, 2002
- Accurate and rapid analysis of residual disease in patients with CML using specific fluorescent hybridization probes for real time quantitative RT-PCRLeukemia, 1999