title: 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.
abstract: 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.
authors.affiliation: Department of Cellular Biotechnologies and Hematology, La Sapienza University, Via Benevento 6, 00161 Rome, Italy. vignetti@bce.uniroma1.it
authors.forename: Marco
authors.initials: M
authors.lastname: Vignetti
authors.forename: Paola
authors.initials: P
authors.lastname: Fazi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cimino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Raimondo
authors.forename: Felicetto
authors.initials: F
authors.lastname: Ferrara
authors.forename: Giovanna
authors.initials: G
authors.lastname: Meloni
authors.forename: Achille
authors.initials: A
authors.lastname: Ambrosetti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Quarta
authors.forename: Livio
authors.initials: L
authors.lastname: Pagano
authors.forename: Giovanna
authors.initials: G
authors.lastname: Rege-Cambrin
authors.forename: Loredana
authors.initials: L
authors.lastname: Elia
authors.forename: Raffaello
authors.initials: R
authors.lastname: Bertieri
authors.forename: Luciana
authors.initials: L
authors.lastname: Annino
authors.forename: Robin
authors.initials: R
authors.lastname: Foà
authors.forename: Michele
authors.initials: M
authors.lastname: Baccarani
authors.forename: Franco
authors.initials: F
authors.lastname: Mandelli
mesh_terms: 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
chemical_list: D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D013256:Steroids; D000068877:Imatinib Mesylate; D016044:Fusion Proteins, bcr-abl