Predictive Factors for Outcome and Response in Patients Treated with Second-generation Tyrosine Kinase Inhibitors for Chronic Myeloid Leukemia in Chronic Phase After Imatinib Failure

Overview

Journal Blood

Publisher Elsevier

Specialty Hematology

Date 2010 Oct 30

PMID 21030554

Citations 31

Authors

Elias Jabbour

Hagop Kantarjian

Susan OBrien

Jenny Shan

Guillermo Garcia-Manero

William Wierda

Farhad Ravandi

Gautam Borthakur

Mary Beth Rios

Jorge Cortes

Affiliations

Soon will be listed here.

Abstract

We assessed the predictive factors for outcome and response in 123 patients with chronic myeloid leukemia in chronic phase treated with second-generation tyrosine kinase inhibitors (TKIs) after imatinib failure. Better event-free survival rates with second-generation TKI therapy were associated with a previous cytogenetic response to imatinib (P < .001) and a performance status of 0 (P = .001). Patients with 0, 1, or 2 adverse factors had 2-year event-free survival rates of 78%, 49%, and 20% (P < .001), respectively; 2-year overall survival rates of 95%, 85%, and 40%, (P = .002), respectively; and a 12-month probability of achieving a major cytogenetic response of 64%, 36%, and 20% (P = .007), respectively. In conclusion, patients with poor performance status and no previous cytogenetic response to imatinib therapy have a low likelihood of responding to second-generation TKI with poor event-free survival and therefore should be offered additional treatment options. This scoring system could serve to advise patients of their prognosis and treatment options, as well as to evaluate the benefit of newer alternate options.

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