Managing chronic myeloid leukaemia in the elderly with intermittent imatinib treatment.

Autor: Russo D; Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy., Malagola M; Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy., Skert C; Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy., Cancelli V; Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy., Turri D; Ematologia 1-TMO, AOR Villa Sofia-Cervello, Palermo, Italy., Pregno P; S.C. Ematologia, Dipartimento di Oncologia ed Ematologia, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy., Bergamaschi M; Dipartimento di Terapie Oncologiche Integrate, IRCCS AOU S. Martino-IST, Genova, Italy., Fogli M; Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy., Testoni N; Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy., De Vivo A; Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy., Castagnetti F; Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy., Pungolino E; Division of Hematology, Department of Oncology and Hematology, Niguarda Ca' Granda Hospital, Milan, Italy., Stagno F; Divisione Clinicizzata di Ematologia AOU Policlinico-V. Emanuele, University of Catania, Catania, Italy., Breccia M; Azienda Policlinico Umberto I, Sapienza Università, Roma, Italy., Martino B; Hematology Unit, 'Bianchi-Melacrino-Morelli' Hospital, Reggio Calabria, Italy., Intermesoli T; Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy., Cambrin GR; University of Turin, San Luigi Gonzaga Hospital, Turin, Italy., Nicolini G; Hematology and Hematopoietic Stem Cell Transplant Center, San Salvatore Hospital, Pesaro, Italy., Abruzzese E; Hematology, S Eugenio Hospital Tor Vergata University, Rome, Italy., Tiribelli M; Division of Hematology and BMT, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy., Bigazzi C; Hematology, Mazzoni Hospital, Ascoli Piceno, Italy., Usala E; U O Ematologia e CTMO Ospedale A., Businco-Cagliari, Italy., Russo S; UOC Ematologia AOU 'G Martino' Policlinico Universitario di Messina, Messina, Italy., Russo-Rossi A; Division of Hematology, University of Bari, Bari, Italy., Lunghi M; Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy., Bocchia M; Hematology and Transplants, University of Siena and AOUS, Siena, Italy., D'Emilio A; Department of Cellular Therapies and Haematology, San Bortolo Hospital, Vicenza, Italy., Santini V; Unità di Ematologia, AOU Careggi, University of Florence, Florence, Italy., Girasoli M; Hematology Department, 'A. Perrino' Hospital, Brindisi, Italy., Lorenzo RD; Division of Haematology, Spirito Santo Hospital, Pescara, Italy., Bernardi S; Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy., Palma AD; Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy., Cesana BM; DMMT, Unit of Medical Statistics, University of Brescia, Brescia, Italy., Soverini S; Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy., Martinelli G; Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy., Rosti G; Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy., Baccarani M; Department of Haematology-Oncology 'L. and A. Seràgnoli' - S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
Jazyk: angličtina
Zdroj: Blood cancer journal [Blood Cancer J] 2015 Sep 18; Vol. 5, pp. e347. Date of Electronic Publication: 2015 Sep 18.
DOI: 10.1038/bcj.2015.75
Abstrakt: The aim of this study was to investigate the effects of a non-standard, intermittent imatinib treatment in elderly patients with Philadelphia-positive chronic myeloid leukaemia and to answer the question on which dose should be used once a stable optimal response has been achieved. Seventy-six patients aged ⩾65 years in optimal and stable response with ⩾2 years of standard imatinib treatment were enrolled in a study testing a regimen of intermittent imatinib (INTERIM; 1-month on and 1-month off). With a minimum follow-up of 6 years, 16/76 patients (21%) have lost complete cytogenetic response (CCyR) and major molecular response (MMR), and 16 patients (21%) have lost MMR only. All these patients were given imatinib again, the same dose, on the standard schedule and achieved again CCyR and MMR or an even deeper molecular response. The probability of remaining on INTERIM at 6 years was 48% (95% confidence interval 35-59%). Nine patients died in remission. No progressions were recorded. Side effects of continuous treatment were reduced by 50%. In optimal and stable responders, a policy of intermittent imatinib treatment is feasible, is successful in about 50% of patients and is safe, as all the patients who relapsed could be brought back to optimal response.
Databáze: MEDLINE