title: Treatment of consecutive patients with chronic myeloid leukaemia in the cooperating centres from the Czech Republic and the whole of Slovakia after 2000--a report from the population-based CAMELIA Registry.
abstract: BACKGROUND
  Most results on the treatment of chronic myeloid leukaemia (CML) with imatinib were obtained from clinical trials that may differ from the routine practice. We report the results of treatment of consecutive patients with CML at ten major centres during 2000-2008.
  
  
  METHODS
  Data reporting was retrospective in 2000-2004 and prospective from 2005 on. A total of 661 patients [301 women and 360 men; median age 51 (range, 15-83)] with Ph+CML were registered. The median follow-up was 46.1 months (0-122.2).
  
  
  RESULTS
  Most patients were treated with first- (379; 57.3%) or second-line (193; 29.2%) imatinib; some of the patients underwent allogeneic hematopoietic stem cell transplantation (AHSCT) (83; 12.6%), but 6.1% were treated with other modalities [40 patients; median age 66 (range, 32-83)]. The probability of overall survival (OS) at 5 years, according to Kaplan and Meier, was 88.9%, 77.5% and 68.7% for chronic-phase patients treated with first-line imatinib, second-line imatinib and first-line AHSCT, respectively, but only 25.2% for patients receiving other modalities. The OS was dependent on the disease phase and Sokal, Hasford and European group for blood and marrow transplantation (EBMT) risk scores (P<0.001; each). Only 46.2% of deaths in patients treated with other modalities were attributable to CML. Elderly patients over 65 years achieved similar response rates and progression-free survival to the younger ones. There was a trend for inferior results of AHSCT performed after the failure of imatinib (P=0.075), probably as a result of differences in EBMT risk scores (P<0.001).
  
  
  CONCLUSIONS
  The ability to achieve results comparable to those of previous clinical studies in our CML cohort was influenced by centralised care. Decisions not to initiate imatinib or to delay AHSCT may have a negative impact on OS, but comorbidities may limit the treatment potential of imatinib in the elderly.
authors.affiliation: Department of Hemato-Oncology, University Hospital, Olomouc, Czech Republic. edgar.faber@fnol.cz
authors.forename: Edgar
authors.initials: E
authors.lastname: Faber
authors.forename: Jan
authors.initials: J
authors.lastname: Mužík
authors.forename: Vladimír
authors.initials: V
authors.lastname: Koza
authors.forename: Eva
authors.initials: E
authors.lastname: Demečková
authors.forename: Jaroslava
authors.initials: J
authors.lastname: Voglová
authors.forename: Ludmila
authors.initials: L
authors.lastname: Demitrovičová
authors.forename: Juraj
authors.initials: J
authors.lastname: Chudej
authors.forename: Imrich
authors.initials: I
authors.lastname: Markuljak
authors.forename: Eduard
authors.initials: E
authors.lastname: Cmunt
authors.forename: Tomáš
authors.initials: T
authors.lastname: Kozák
authors.forename: Elena
authors.initials: E
authors.lastname: Tóthová
authors.forename: Marie
authors.initials: M
authors.lastname: Jarošová
authors.forename: Ladislav
authors.initials: L
authors.lastname: Dušek
authors.forename: Karel
authors.initials: K
authors.lastname: Indrák
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides; D018153:Czech Republic / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000068877:Imatinib Mesylate; D053208:Kaplan-Meier Estimate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use; D011446:Prospective Studies; D011743:Pyrimidines / Q000627:therapeutic use; D012042:Registries; D012189:Retrospective Studies; D018154:Slovakia / Q000453:epidemiology; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate