Imatinib plus steroids induces complete remissions and prolonged survival in elderly Philadelphia chromosome-positive patients with acute lymphoblastic leukemia without additional chemotherapy: results of the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA) LAL0201-B protocol.
Thirty elderly (> 60 years) Philadelphia chromosome-positive (Ph(+)) patients with acute lymphoblastic leukemia (ALL) received imatinib, 800 mg daily, associated to steroids without further chemotherapy as frontline treatment. Median age was 69 years (range, 61-83 years). Twenty-nine patients were evaluable for response and all of them obtained a hematologic complete remission, with a median BCR-ABL reduction of 2.9 and 2.0 logs in p190(+) and p210(+) cases, respectively. Most of the induction treatment did not require admission of the patients. No major toxicities occurred and the treatment was well tolerated. Median survival from diagnosis was 20 months. This study shows that elderly Ph(+) patients with ALL-often considered eligible only for palliative treatment strategies-may benefit from an imatinib-steroids protocol, which does not require chemotherapy nor a long hospitalization, is feasible, highly active, and associated with a good quality of life.
Vignetti
Marco
M
Department of Cellular Biotechnologies and Hematology, La Sapienza University, Via Benevento 6, 00161 Rome, Italy. vignetti@bce.uniroma1.it
Fazi
Paola
P
Cimino
Giuseppe
G
Martinelli
Giovanni
G
Di Raimondo
Francesco
F
Ferrara
Felicetto
F
Meloni
Giovanna
G
Ambrosetti
Achille
A
Quarta
Giovanni
G
Pagano
Livio
L
Rege-Cambrin
Giovanna
G
Elia
Loredana
L
Bertieri
Raffaello
R
Annino
Luciana
L
Foà
Robin
R
Baccarani
Michele
M
Mandelli
Franco
F
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D001549:Benzamides; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D016044:Fusion Proteins, bcr-abl / Q000235:genetics; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects; D012074:Remission Induction; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects; D015996:Survival Rate
D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D013256:Steroids; D000068877:Imatinib Mesylate; D016044:Fusion Proteins, bcr-abl