Sustained superior long-term outcomes and cytogenetic responses with imatinib mesylate in chronic phase chronic myeloid leukaemia: report from a developing country.
OBJECTIVE
Imatinib mesylate is now a standard treatment for chronic myeloid leukaemia. Primary objective of our study was to report long-term survival outcomes in patients receiving Imatinib in chronic phase. Secondary objectives included determination of cytogenetic responses and toxicity profile of Imatinib mesylate.


METHODS
Three-hundred and four consecutive patients with chronic phase chronic myeloid leukaemia were evaluated between January 2001 to December 2007, for event-free survival, overall survival, complete cytogenetic response and toxicity profiles. Event-free and overall survivals were calculated by Kaplan-Meier estimates. Cox regression analysis was performed to evaluate the prognostic factors for survival. Univariate and multivariate analyses were performed for factors predictive of a complete cytogenetic response.


RESULTS
Median follow-up was 48 months. Estimated 5-year event-free and overall survivals of all patients were 79% and 86%, respectively. On Cox regression analysis significant predictive factors for event-free survival were age < 50 years (P 0.002), complete cytogenetic response (P < 0.0001), low Sokal score (P 0.007), complete clinical (P < 0.0001) and haematological response (P < 0.0001). Complete cytogenetic response was achieved in 206 (67.8%) patients. On multivariate analysis, low Sokal score (P < 0.0001) and early chronic phase disease (P < 0.0001) emerged as the most significant predictors for achieving a complete cytogenetic response. An estimated 5.8% patients lost their complete cytogenetic response. Grade III/IV toxicity was observed in only 21 patients.


CONCLUSIONS
Long-term treatment with Imatinib mesylate results in superior and durable responses in chronic phase chronic myeloid leukaemia. Our survival outcomes are similar to reported rates in the Western population.
Aziz
Zeba
Z
Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan. azizzeba@gmail.com
Iqbal
Javaid
J
Bano
Kausar
K
Faisal
Muhammad
M
Akram
Muhammad
M
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001549:Benzamides; D020732:Cytogenetic Analysis; D003906:Developing Countries; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D015466:Leukemia, Myeloid, Chronic-Phase / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*; D015996:Survival Rate
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate