Background: A limited amount of data has been published in chronic-phase chronic myeloid leukemia (CP-CML) patients aged >75 years treated frontline with second-generation tyrosine kinase inhibitors.
Aims: To address this issue in a clinical 'real-life' setting, we retrospectively analyzed 45 CP-CML patients (pts) followed in 20 Italian Centers and treated frontline with dasatinib (DAS).
Patients And Methods: Median age was 78.4 years (range 75-89.2 years). DAS starting dose was 100 mg QD in 35 pts (77.7%), 80 mg QD in 1 pts (2.2%) and 50 mg QD in 9 pts (20.1%), respectively. The median follow-up was 42.6 months (IQR 20.4 - 63.3).
Results: Grade 3 and 4 side effects, both hematological and non-hematological, were detected in 6 (13.3%) and 12 (26.6%) pts, respectively. Pleural effusions of all grades occurred in 13 pts (28.8%) after a median period of DAS exposure of 14.7 months (IQR 3.0 - 33.1). The rates of DAS dose reduction and permanent drug discontinuation were 53.3% and 20.0%, respectively. As the best response, 42/45 patients (93.3%) achieved a complete cytogenetic response (CCyR), 35/45 (77.7%) a major molecular response (MMR) and 24/45 (53.3%) a deep molecular response (both MR 4.0 and MR 4.5). Only 1 patient (2.2%) progressed to the blast phase after 13 months of therapy; 8 deaths were observed (1 CML-related and 7 CML-unrelated). Cumulative event-free survival and overall survival at 36 months were 64.7% (95%, CI 49.4 - 80.0) and 82.3% (95%, CI 70.3-94.3), respectively.
Conclusion: These findings, although evaluated in a limited and selected cohort of patients, suggest that DAS might be effective in older patients (aged >75 years) affected by CP-CML with acceptable toxicity.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1080/0284186X.2021.1971292 | DOI Listing |
Value Health
December 2024
Medip Analytics, Netherlands, Gelderland, Nijmegen; Department of Medical Imaging, Radboud University Medical Center, Netherlands, Gelderland, Nijmegen.
Objectives: Chronic myeloid leukemia (CML) management now includes dose-reduction (DR) and treatment-free remission (TFR). Evaluating cost-effectiveness of lifelong-prescribed expensive tyrosine kinase inhibitors (TKIs) for CML is crucial. Prior cost-effectiveness evaluations state that imatinib is the favorable frontline TKI.
View Article and Find Full Text PDFClin Lymphoma Myeloma Leuk
January 2025
Department of Hematology, Università Federico II, Napoli, Italy.
Eur J Haematol
January 2025
Hematology, Belcolle Hospital, Viterbo, Italy.
Cancer Genet
November 2024
Laboratory of Biomedical & Translational Research, Faculty of Medicine, Pharmacy and Dentistry of Fez, Sidi Mohamed Ben Abdellah University, 30000, Fez, Morocco; Medical Genetics & Oncogenetics Laboratory, Hassan II University Hospital, 30000, Fez, Morocco.
Tyrosine Kinase Inhibitors (TKI), such as Imatinib, are known for their effectiveness in achieving complete remission from Chronic Myeloid Leukemia (CML), a malignancy caused by a reciprocal translocation between the terminal fragments of the long arms of chromosomes 9 and 22 that leads to the famous chimeric BCR::ABL1 gene. Mutations in this fusion gene may induce resistance to TKI treatment, which requires prescribing a second-, or third-generation TKI medication. We report here a case of a Moroccan CML patient with secondary resistance to the frontline TKI treatment (Imatinib), in which, BCR::ABL1 cDNA sequencing reveals the novel mutation p.
View Article and Find Full Text PDFBlood
November 2024
Haematology Department, Royal Adelaide Hospital, Adelaide Medical School, University of Adelaide and Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, Australia.
Asciminib is a myristoyl site BCR::ABL1 inhibitor approved for patients with chronic-phase chronic myeloid leukemia (CP-CML) failing ≥2 prior lines of therapy. The Australasian Leukaemia and Lymphoma Group conducted the Asciminib Evaluation in Newly Diagnosed CML study to assess efficacy of asciminib for newly diagnosed CP-CML. Patients commenced asciminib 40 mg twice daily.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!