title: Survival of patients with chronic-phase chronic myeloid leukaemia on imatinib after failure on interferon alfa.
abstract: Until the recent introduction of imatinib, interferon alfa was the standard treatment for patients in the chronic phase of chronic myeloid leukaemia. We compared survival of 143 such patients, who did not respond to interferon alfa and were treated with imatinib, with that of 246 historical controls who received conventional treatment. Patients on imatinib showed an overall survival advantage (relative risk 0.54, 95% CI 0.31-0.93). However, although patients on imatinib who achieved at least some degree of cytogenetic response after 6 months had better survival than controls (0.13, 0.05-0.39), those with no cytogenetic response to imatinib had significantly worse survival (1.69, 1.09-2.64). Our findings suggest that cytogenetic responders obtain benefit from imatinib but patients who show no cytogenetic response should be given alternative treatment without delay. We confirmed these results in a case-matched analysis.
authors.affiliation: Department of Haematology, Hammersmith Hospital, W12 0NN, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Marin
authors.forename: Sarah
authors.initials: S
authors.lastname: Marktel
authors.forename: Richard
authors.initials: R
authors.lastname: Szydlo
authors.forename: John P
authors.initials: JP
authors.lastname: Klein
authors.forename: Marco
authors.initials: M
authors.lastname: Bua
authors.forename: Nicola
authors.initials: N
authors.lastname: Foot
authors.forename: Eduardo
authors.initials: E
authors.lastname: Olavarria
authors.forename: Pat
authors.initials: P
authors.lastname: Shepherd
authors.forename: Edward
authors.initials: E
authors.lastname: Kanfer
authors.forename: John M
authors.initials: JM
authors.lastname: Goldman
authors.forename: Jane F
authors.initials: JF
authors.lastname: Apperley
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D016898:Interferon-alpha / Q000627:therapeutic use*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D011743:Pyrimidines / Q000627:therapeutic use*; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D016898:Interferon-alpha; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate