title: Sustained superior long-term outcomes and cytogenetic responses with imatinib mesylate in chronic phase chronic myeloid leukaemia: report from a developing country.
abstract: 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.
authors.affiliation: Department of Oncology, Allama Iqbal Medical College, Lahore, Pakistan. azizzeba@gmail.com
authors.forename: Zeba
authors.initials: Z
authors.lastname: Aziz
authors.forename: Javaid
authors.initials: J
authors.lastname: Iqbal
authors.forename: Kausar
authors.initials: K
authors.lastname: Bano
authors.forename: Muhammad
authors.initials: M
authors.lastname: Faisal
authors.forename: Muhammad
authors.initials: M
authors.lastname: Akram
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate