Treatment outcome in a population-based, ‘real-world’ cohort of patients with chronic myeloid leukemia
Autor: | Jan J. Cornelissen, Peter E. Westerweel, Inge G.P. Geelen, Sten P. Willemsen, Noortje Thielen, Tanja J.A. Roosma, Otto Visser, Jeroen Janssen, Mels Hoogendoorn |
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Přispěvatelé: | Erasmus MC other, Epidemiology, Hematology, CCA - Cancer Treatment and quality of life |
Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty medicine.drug_class Chronic Myeloid Leukemia Comorbidity Article Tyrosine-kinase inhibitor Cohort Studies 03 medical and health sciences 0302 clinical medicine Leukemia Myelogenous Chronic BCR-ABL Positive Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Public Health Surveillance Cumulative incidence Molecular Targeted Therapy Registries Mortality Protein Kinase Inhibitors Aged Netherlands Hematology Drug Substitution business.industry Myeloid leukemia Imatinib Middle Aged medicine.disease Leukemia Treatment Outcome 030220 oncology & carcinogenesis Cohort Immunology Disease Progression Female business Tyrosine kinase 030215 immunology medicine.drug |
Zdroj: | Haematologica, 102(11), 1842-1849. Ferrata Storti Foundation Geelen, I G P, Thielen, N, Janssen, J J W M, Hoogendoorn, M, Roosma, T J A, Willemsen, S P, Visser, O, Cornelissen, J J & Westerweel, P E 2017, ' Treatment outcome in a population-based, ‘real-world’ cohort of patients with chronic myeloid leukemia ', Haematologica, vol. 102, no. 11, pp. 1842-1849 . https://doi.org/10.3324/haematol.2017.174953 Haematologica |
ISSN: | 0390-6078 |
DOI: | 10.3324/haematol.2017.174953 |
Popis: | Evaluations of the ‘real-world’ efficacy and safety of tyrosine kinase inhibitors in patients with chronic myeloid leukemia are scarce. A nationwide, population-based, chronic myeloid leukemia registry was analyzed to evaluate (deep) response rates to first and subsequent treatment lines and eligibility for a treatment cessation attempt in adults diagnosed between January 2008 and April 2013 in the Netherlands. The registry covered 457 patients; 434 in chronic phase (95%) and 15 (3%) in advanced disease phase. Seventy-five percent of the patients in chronic phase were treated with imatinib and 25% with a second-generation tyrosine kinase inhibitor. At 3 years 44% of patients had discontinued their first-line treatment, mainly due to intolerance (21%) or treatment failure (19%). At 18 months 73% of patients had achieved a complete cytogenetic response and 63% a major molecular response. Deep molecular responses (MR4.0 and MR4.5) were achieved in 69% and 56% of patients, respectively, at 48 months. All response milestones were achieved faster in patients treated upfront with a second-generation tyrosine kinase inhibitor, but ultimately patients initially treated with imatinib also reached similar levels of responses. The 6-year cumulative incidence of eligibility for a tyrosine kinase cessation attempt, according to EURO-SKI criteria, was 31%. Our findings show that in a ‘real-world’ setting the long-term outcome of patients treated with tyrosine kinase inhibitors is excellent and the conditions for an attempt to stop tyrosine kinase inhibitor therapy are met by a third of the patients. |
Databáze: | OpenAIRE |
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