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Medline ® Abstract for Reference 54

of 'Treatment of chronic myeloid leukemia in chronic phase after failure of initial therapy'

54
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Imatinib mesylate dose escalation is associated with durable responses in patients with chronic myeloid leukemia after cytogenetic failure on standard-dose imatinib therapy.
AU
Jabbour E, Kantarjian HM, Jones D, Shan J, O'Brien S, Reddy N, Wierda WG, Faderl S, Garcia-Manero G, Verstovsek S, Rios MB, Cortes J
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Blood. 2009;113(10):2154. Epub 2008 Dec 5.
 
We assessed the long-term efficacy of imatinib dose escalation in 84 patients with chronic myeloid leukemia in chronic phase who met the criteria of failure to standard-dose imatinib. Twenty-one patients with hematologic failure and 63 with cytogenetic failure had their imatinib dose escalated from 400 to 800 mg daily (n = 72) or from 300 to 600 mg daily (n = 12). After a median follow-up of 61 months from dose escalation, 69% remained alive. Complete cytogenetic responses were achieved in 40%; including 52% of patients with cytogenetic failure and 5% of those with hematologic failure. The estimated 2- and 3-year event-free survival and overall survival rates were 57% and 47%, and 84% and 76%, respectively. Responses were long-lasting; 88% of patients with major cytogenetic response sustained their response beyond 2 years. Treatment was well tolerated, with 76% of patients, at 12 months, continuing to receive imatinib at 100% of the intended dose. In conclusion, imatinib dose escalation can induce sustained responses in a subset of patients with cytogenetic failure and a previous cytogenetic response to standard-dose imatinib.
AD
Department of Leukemia, University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA.
PMID