title: Response to treatment with imatinib mesylate in previously treated chronic-phase chronic myeloid leukemia patients in a hospital in Brazil.
abstract: We  analyzed the results of treatment with imatinib mesylate in 70 patients with  chronic-phase chronic myeloid leukemia who had previously been treated (with  second-line or higher imatinib), many of them in a late chronic phase. The  median follow-up period was 60.5 months (range 3-100 months). Our objective was  to assess the efficacy and safety of treatment. The mean dose was 400 mg per  day. The hematologic response rate was 92.1% at six months, while the  cumulative rates of major and complete cytogenetic responses were 73.6 and  66.3%, respectively. Molecular response rate improved slowly and steadily over  time, reaching 65.8% at 60 months, remaining stable for up to 96 months. The  five-year progression-free survival and overall survival were 84 and 89%,  respectively. Cytogenetic response by 12 months significantly correlated with  overall survival (P = 0.0007) and progression-free survival (P = 0.0280). Sokal  risk score did not differ significantly between subgroups. The medication was  well tolerated, with only 16% of patients showing hematologic toxicity grades 3  and 4. At the end of the assessment, 57% of the patients were still on imatinib  mesylate; most of those who discontinued treatment (17/30) did so because of  unsatisfactory response. Treatment with imatinib mesylate in previously treated  chronic-phase chronic myeloid leukemia induced durable responses in a high  proportion of patients and was related to satisfactory long-term and event-free  survival.
authors.affiliation: Núcleo de Hematologia e Hemoterapia, Hospital de Base do Distrito Federal, Secretaria de Estado da Saúde do Distrito Federal, Brasília, DF, Brasil. carlosapsilveira@gmail.com
authors.forename: C A P
authors.initials: CA
authors.lastname: Silveira
authors.forename: M B
authors.initials: MB
authors.lastname: Daldegan
authors.forename: I
authors.initials: I
authors.lastname: Ferrari
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001549:Benzamides; D001938:Brazil; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D015466:Leukemia, Myeloid, Chronic-Phase / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate