title: Comorbidities and polypharmacy impact on complete cytogenetic response in chronic myeloid leukaemia elderly patients.
abstract: BACKGROUND
  In older patients comorbidity and polypharmacy can significantly influence the success of the treatment, as well as the cognitive and psycho-social aspects. A significant proportion of chronic myeloid leukaemia (CML) patients are "elderly": in the past the aim of therapy in this subset of patients was only to contain the leukaemic mass, but nowadays, with the advent of the protein-tyrosine kinase inhibitors, also elderly patients can access these treatments. We want to assess if even old CML patients, with a correct geriatric evaluation, can be successfully treated with protein-tyrosine kinase inhibitors.
  
  
  METHODS
  A complete geriatric evaluation in 16 old CML patients aged >65years treated with TKI was performed in order to assess the comorbidity, the polypharmacy and the cognitive, physical and psychological states. The Charlson comorbity index (CCI) and the polypharmacy were correlated to the obtained cytogenetic response. Seven scales of geriatric evaluation were used to assess the autonomy of patients before they were included into the study.
  
  
  RESULTS
  In our cohort of elderly patients treated with imatinib, comorbidities and polypharmaco-therapy demonstrated an influence on TKI therapeutic success. In fact, the majority of complete cytogenetic response was obtained by patients who presented a low score of CCI and did not take any other drugs other than TKI.
  
  
  CONCLUSIONS
  Also old chronic myeloid leukaemia patients can benefit from TKI treatment if a good cooperation between the haematologist and the geriatrician is established.
authors.affiliation: Hematology and Transplantation Unit, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico and University of Milan, Italy. Electronic address: aiurlo@policlinico.mi.it.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Iurlo
authors.affiliation: Geriatrics, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico and Department of Clinical Sciences and Community Health, University of Milan, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Ubertis
authors.affiliation: Hematology and Transplantation Unit, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico and University of Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Artuso
authors.affiliation: Hematology and Transplantation Unit, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico and University of Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Bucelli
authors.affiliation: Hematology and Transplantation Unit, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico and University of Milan, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Radice
authors.affiliation: Hematology and Transplantation Unit, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico and University of Milan, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Zappa
authors.affiliation: Hematology and Transplantation Unit, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico and University of Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Cattaneo
authors.affiliation: Geriatrics, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico and Department of Clinical Sciences and Community Health, University of Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Mari
authors.affiliation: Hematology and Transplantation Unit, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico and University of Milan, Italy.
authors.forename: Agostino
authors.initials: A
authors.lastname: Cortelezzi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D004347:Drug Interactions; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D010879:Piperazines / Q000627:therapeutic use*; D019338:Polypharmacy; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011743:Pyrimidines / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases
keywords: Chronic myeloid leukaemia; Comorbidity; Drug interactions; Elderly; Polypharmacy; Tyrosine kinase inhibitors