Imatinib in patients with newly diagnosed chronic-phase chronic myeloid leukemia.
The International Randomized Study of Interferon and STI571 (IRIS) study prospectively compared imatinib with interferon-alpha/low-dose cytarabine (IFN/LDAC) in 1,106 newly diagnosed patients with Philadelphia chromosome-positive chronic myeloid leukemia (CML). Patients not responding to or intolerant of their assigned treatment were allowed to cross over. At 18 months, the projected probability of achieving a complete cytogenetic response was 76.2% for imatinib and 14.5% for IFN/LDAC, respectively (P <.01). Freedom from progression to accelerated phase or blast crisis was 96.7% for imatinib versus 91.5% for IFN/LDAC (P <.01). At the time of the analysis, 85.7% of imatinib-treated patients continued on first-line therapy, but only 10.8% of patients continued with IFN/LDAC. Most cross-overs to imatinib were due to interferon-intolerance. Overall survival was not different in the two groups at 19 months, reflecting efficient rescue of IFN/LDAC failures with imatinib. Imatinib should now be considered the standard therapy for newly diagnosed patients with CML.
O'Brien
Stephen G
SG
School of Clinical and Laboratory Sciences, The Medical School, University of Newcastle, Newcastle, UK.
Deininger
Michael W N
MW
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001549:Benzamides; D003561:Cytarabine / Q000627:therapeutic use; D020732:Cytogenetic Analysis; D018450:Disease Progression; D006801:Humans; D000068877:Imatinib Mesylate; D016898:Interferon-alpha / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000401:mortality; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D012074:Remission Induction; D016896:Treatment Outcome
D001549:Benzamides; D016898:Interferon-alpha; D010879:Piperazines; D011743:Pyrimidines; D003561:Cytarabine; D000068877:Imatinib Mesylate