Prognostic factors for patients with chronic myeloid leukaemia in chronic phase treated with imatinib mesylate after failure of interferon alfa.
We assessed clinical results in 145 patients with chronic myeloid leukaemia in chronic phase who satisfied criteria for interferon-alpha failure and were thus eligible for treatment with imatinib at the Hammersmith Hospital. We used univariate and multivariate analyses to develop a risk score based on features defined after treatment for 3 months. We identified a low neutrophil count and poor cytogenetic response (<35% Ph-negative marrow metaphases) at 3 months as principal independent predictive factors and incorporated them into a three-tier prognostic scoring system for individual patients. For patients in the low-, intermediate- and high-risk groups, the probabilities of survival at 24 months were 100, 82 and 40% (P<0.0001) and progression-free survival 100, 66 and 15% (P<0.0001), respectively. This Hammersmith prognostic scoring system was validated with an independent cohort of patients treated at another UK centre.
Marin
D
D
Department of Haematology, Imperial College London at Hammersmith Hospital, London, UK.
Marktel
S
S
Bua
M
M
Szydlo
R M
RM
Franceschino
A
A
Nathan
I
I
Foot
N
N
Crawley
C
C
Na Nakorn
T
T
Olavarria
E
E
Lennard
A
A
Neylon
A
A
O'Brien
S G
SG
Goldman
J M
JM
Apperley
J F
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D001549:Benzamides; D020732:Cytogenetic Analysis; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000068877:Imatinib Mesylate; D016898:Interferon-alpha / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use*; D011379:Prognosis; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use*; D018570:Risk Assessment; D016879:Salvage Therapy / Q000379:methods* / Q000401:mortality; D012720:Severity of Illness Index; D016019:Survival Analysis; D017211:Treatment Failure
D001549:Benzamides; D016898:Interferon-alpha; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate