title: Younger patients with chronic myeloid leukemia do well in spite of poor prognostic indicators: results from the randomized CML study IV.
abstract: Since the advent of tyrosine kinase inhibitors, the impact of age on outcome of chronic myeloid leukemia (CML) patients has changed. We therefore analyzed patients from the randomized CML study IV to investigate disease manifestations and outcome in different age groups. One thousand five hundred twenty-four patients with BCR-ABL-positive chronic phase CML were divided into four age groups: (1) 16-29 years, n = 120; (2) 30-44 years, n = 383; (3) 45-59 years, n = 495; and (4) ≥60 years, n = 526. Group 1 (adolescents and young adults (AYAs)) presented with more aggressive disease features (larger spleen size, more frequent symptoms of organomegaly, higher white blood count, higher percentage of peripheral blasts and lower hemoglobin levels) than the other age groups. In addition, a higher rate of patients with BCR-ABL transcript levels >10 % on the international scale (IS) at 3 months was observed. After a median observation time of 67.5 months, no inferior survival and no differences in cytogenetic and molecular remissions or progression rates were observed. We conclude that AYAs show more aggressive features and poor prognostic indicators possibly indicating differences in disease biology. This, however, does not affect outcome.
authors.affiliation: III. Medizinische Klinik, Universitätsmedizin Mannheim, Pettenkoferstrasse 22, 68169, Mannheim, Germany.
authors.forename: Lida
authors.initials: L
authors.lastname: Kalmanti
authors.forename: Susanne
authors.initials: S
authors.lastname: Saussele
authors.forename: Michael
authors.initials: M
authors.lastname: Lauseker
authors.forename: Ulrike
authors.initials: U
authors.lastname: Proetel
authors.forename: Martin C
authors.initials: MC
authors.lastname: Müller
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hanfstein
authors.forename: Annette
authors.initials: A
authors.lastname: Schreiber
authors.forename: Alice
authors.initials: A
authors.lastname: Fabarius
authors.forename: Markus
authors.initials: M
authors.lastname: Pfirrmann
authors.forename: Susanne
authors.initials: S
authors.lastname: Schnittger
authors.forename: Jolanta
authors.initials: J
authors.lastname: Dengler
authors.forename: Christiane
authors.initials: C
authors.lastname: Falge
authors.forename: Lothar
authors.initials: L
authors.lastname: Kanz
authors.forename: Andreas
authors.initials: A
authors.lastname: Neubauer
authors.forename: Frank
authors.initials: F
authors.lastname: Stegelmann
authors.forename: Michael
authors.initials: M
authors.lastname: Pfreundschuh
authors.forename: Cornelius F
authors.initials: CF
authors.lastname: Waller
authors.forename: Karsten
authors.initials: K
authors.lastname: Spiekermann
authors.forename: Stefan W
authors.initials: SW
authors.lastname: Krause
authors.forename: Dominik
authors.initials: D
authors.lastname: Heim
authors.forename: Christoph
authors.initials: C
authors.lastname: Nerl
authors.forename: Dieter K
authors.initials: DK
authors.lastname: Hossfeld
authors.forename: Hans-Jochem
authors.initials: HJ
authors.lastname: Kolb
authors.forename: Andreas
authors.initials: A
authors.lastname: Hochhaus
authors.forename: Joerg
authors.initials: J
authors.lastname: Hasford
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Hehlmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001549:Benzamides / Q000008:administration & dosage / Q000627:therapeutic use; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D016044:Fusion Proteins, bcr-abl / Q000097:blood / Q000235:genetics; D006801:Humans; D000068877:Imatinib Mesylate; D016898:Interferon-alpha / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D015466:Leukemia, Myeloid, Chronic-Phase / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use; D012333:RNA, Messenger / Q000097:blood; D012334:RNA, Neoplasm / Q000097:blood; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012307:Risk Factors; D013163:Splenomegaly / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001549:Benzamides; D016898:Interferon-alpha; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D003561:Cytarabine; D000068877:Imatinib Mesylate; D016044:Fusion Proteins, bcr-abl