title: Chronic myeloid leukemia and interferon-alpha: a study of complete cytogenetic responders.
abstract: Achieving a complete cytogenetic response (CCgR) is a major target in the treatment of chronic myeloid leukemia (CML) with interferon-alpha (IFN-alpha), but CCgRs are rare. The mean CCgR rate is 13%, in a range of 5% to 33%. A collaborative study of 9 European Union countries has led to the collection of data on 317 patients who were first seen between 1983 and 1997 and achieved CCgRs with IFN-alpha alone or in combination with hydroxyurea. The median time to first CCgR was 19 months (95% CI, 17-21; range, 3-84 months). At last contact, 212 patients were still alive and in continuous CCgR; 105 patients had lost CCgR, but 53% of them were still alive and in chronic phase. IFN-alpha treatment was discontinued permanently in 23 cases for response loss, in 36 cases for chronic toxicity (15 are still in unmaintained continuous CCgR), and in 8 cases because it was believed that treatment was no longer necessary (7 of these 8 patients are still in unmaintained continuous CCgR). The 10-year survival rate from first CCgR is 72% (95% CI, 62%-82%) and is related to the risk profile. High-risk patients lost CCgR more frequently and more rapidly and none survived more than 10 years. Low-risk patients survived much longer (10-year survival probability 89% for Sokal low risk and 81% for Euro low risk). These data point out that a substantial long-term survival in CCgRs is restricted mainly to low-risk and possibly intermediate-risk patients and occurs significantly less often in high-risk patients.
authors.forename: F
authors.initials: F
authors.lastname: Bonifazi
authors.forename: A
authors.initials: A
authors.lastname: de Vivo
authors.forename: G
authors.initials: G
authors.lastname: Rosti
authors.forename: F
authors.initials: F
authors.lastname: Guilhot
authors.forename: J
authors.initials: J
authors.lastname: Guilhot
authors.forename: E
authors.initials: E
authors.lastname: Trabacchi
authors.forename: R
authors.initials: R
authors.lastname: Hehlmann
authors.forename: A
authors.initials: A
authors.lastname: Hochhaus
authors.forename: P C
authors.initials: PC
authors.lastname: Shepherd
authors.forename: J L
authors.initials: JL
authors.lastname: Steegmann
authors.forename: H C
authors.initials: HC
authors.lastname: Kluin-Nelemans
authors.forename: J
authors.initials: J
authors.lastname: Thaler
authors.forename: B
authors.initials: B
authors.lastname: Simonsson
authors.forename: A
authors.initials: A
authors.lastname: Louwagie
authors.forename: J
authors.initials: J
authors.lastname: Reiffers
authors.forename: F X
authors.initials: FX
authors.lastname: Mahon
authors.forename: E
authors.initials: E
authors.lastname: Montefusco
authors.forename: G
authors.initials: G
authors.lastname: Alimena
authors.forename: J
authors.initials: J
authors.lastname: Hasford
authors.forename: S
authors.initials: S
authors.lastname: Richards
authors.forename: G
authors.initials: G
authors.lastname: Saglio
authors.forename: N
authors.initials: N
authors.lastname: Testoni
authors.forename: G
authors.initials: G
authors.lastname: Martinelli
authors.forename: S
authors.initials: S
authors.lastname: Tura
authors.forename: M
authors.initials: M
authors.lastname: Baccarani
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D016026:Bone Marrow Transplantation; D002423:Cause of Death; D003131:Combined Modality Therapy; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D016044:Fusion Proteins, bcr-abl / Q000097:blood; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000628:therapy; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D007155:Immunologic Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D016044:Fusion Proteins, bcr-abl