Outcomes of Dose Escalation of Imatinib in Chronic Myeloid Leukemia Patients: A Retrospective Analysis From an Indian University Teaching Hospital.

Autor:	Yadav R; Medical Oncology, Gujarat Cancer & Research Institute (GCRI) and B J Medical College (BJMC), Ahmedabad, IND., Panchal H; Medical Oncology, Gujarat Cancer & Research Institute (GCRI) and B J Medical College (BJMC), Ahmedabad, IND., Patel A; Medical Oncology, Gujarat Cancer & Research Institute (GCRI) and B J Medical College (BJMC), Ahmedabad, IND., Parikh S; Medical Oncology, Gujarat Cancer & Research Institute (GCRI) and B J Medical College (BJMC), Ahmedabad, IND., Shah K; Medical Oncology, Gujarat Cancer & Research Institute (GCRI) and B J Medical College (BJMC), Ahmedabad, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 01; Vol. 16 (10), pp. e70622. Date of Electronic Publication: 2024 Oct 01 (Print Publication: 2024).
DOI:	10.7759/cureus.70622
Abstrakt:	Background: Chronic myeloid leukemia (CML) treatment in low- and middle-income countries faces significant financial and logistical constraints. In scenarios where second-line tyrosine kinase inhibitors (TKIs) are unavailable or unaffordable, dose escalation of imatinib provides an alternative. This study evaluates the efficacy, safety, and progression-free survival (PFS) outcomes of dose escalation of imatinib in CML patients who experienced suboptimal response or progression on standard doses. Methods: A retrospective analysis of 123 CML patients treated at an Indian university teaching hospital from 2013 to 2016 was conducted. Patients who showed progression on a 400 mg dose of imatinib were escalated to 600 mg, and further to 800 mg if required. Demographic data, progression, and toxicity were analyzed. Results: Out of 123 patients, 78 (63.4%) showed a complete hematologic response after dose escalation. The median PFS was 48 months, with a three-year PFS rate of 67%. Notable toxicities included Grade 3/4 neutropenia in 15% and gastrointestinal disturbances in 12%. Comparatively, studies suggest that switching to a second-line TKI in similar settings results in a higher PFS; however, our findings underscore that dose escalation of imatinib remains a viable alternative when financial constraints limit access to second-line therapies. Conclusion: In resource-constrained settings, dose escalation of imatinib can be an effective strategy for managing CML patients who progress on standard doses. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Yadav et al.)
Databáze:	MEDLINE
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