title: Clinical characteristics and therapeutic outcomes of elderly patients with chronic myeloid leukemia: A retrospective multicenter study.
abstract: OBJECTIVE
  We aimed to investigate whether older age leads to limitations in the starting dose of imatinib in daily treatment of chronic myeloid leukemia, and to determine the compliance of elderly patients with tyrosine kinase inhibitors (TKI) therapy.
  
  
  METHODS
  Data including the clinical characteristics, therapeutic outcomes and compliance with TKI therapy of elderly patients with chronic myeloid leukemia aged >65 years were collected from 13 institutions in Turkey, retrospectively.
  
  
  RESULTS
  A total of 69 patients (27 [39%] men, 42 [61%] women) were evaluated retrospectively. The median age of the patients was 71 years (range 66-85 years). Of the patients, 66 (96%) were in the chronic phase and three (4.3%) were in the accelerated phase when diagnosed. A total of 63 (91.3%) patients were receiving imatinib as the first-line therapy. The initial dose of imatinib was 400 mg/day in 59 patients (93.6%). Imatinib treatment induced 57 (90.5%) complete hematological responses at 3 months, 29 (46%) complete cytogenetic responses at 6 months and 49 (77.7%) major molecular responses at 12 months. As a result, nilotinib and dasatinib were used in 14 patients as second-line therapy. Second-line TKI induced nine complete hematological responses (64.3%) at 3 months, four complete cytogenetic responses (28.6%) at 12 months and seven major molecular responses (50%) at 18 months. A total of 56 of the patients (81.2%) are still alive. The median overall survival and progression-free survival rates were 35 months (range 1-95 months) and 17 months (range 0.8-95 months), respectively.
  
  
  CONCLUSIONS
  Elderly patients should receive TKI according to the same guidelines that apply to younger patients.
authors.affiliation: Division of Hematology, Kayseri Education and Research Hospital, Kayseri, Turkey.
authors.forename: Serdal
authors.initials: S
authors.lastname: Korkmaz
authors.affiliation: Department of Hematology, Dicle University, Diyarbakir, Turkey.
authors.forename: Mehmet Sinan
authors.initials: MS
authors.lastname: Dal
authors.affiliation: Department of Hematology, Inonu University, Malatya, Turkey.
authors.forename: Ilhami
authors.initials: I
authors.lastname: Berber
authors.affiliation: Department of Hematology, Osmangazi University, Eskisehir, Turkey.
authors.forename: Deniz Goren
authors.initials: DG
authors.lastname: Sahin
authors.affiliation: Department of Hematology, Pamukkale University, Denizli, Turkey.
authors.forename: Mehmet Hilmi
authors.initials: MH
authors.lastname: Dogu
authors.affiliation: Department of Hematology, Dicle University, Diyarbakir, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Ayyildiz
authors.affiliation: Department of Hematology, Inonu University, Malatya, Turkey.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Nizam
authors.affiliation: Department of Hematology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Albayrak
authors.affiliation: Department of Hematology, Yuzuncu Yil University, Van, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Esen
authors.affiliation: Department of Hematology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Sinem
authors.initials: S
authors.lastname: Namdaroglu
authors.affiliation: Department of Hematology, Cumhuriyet University, Sivas, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sencan
authors.affiliation: Department of Hematology, Osmangazi University, Eskisehir, Turkey.
authors.forename: Olga Meltem
authors.initials: OM
authors.lastname: Akay
authors.affiliation: Department of Hematology, Pamukkale University, Denizli, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Hacioglu
authors.affiliation: Department of Hematology, Ataturk University, Erzurum, Turkey.
authors.forename: Rahsan
authors.initials: R
authors.lastname: Yildirim
authors.affiliation: Department of Hematology, Marmara University, Istanbul, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Eser
authors.affiliation: Department of Hematology, Mersin University, Mersin, Turkey.
authors.forename: Anil
authors.initials: A
authors.lastname: Tombak
authors.affiliation: Department of Hematology, Erciyes University, Kayseri, Turkey.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Pala
authors.affiliation: Department of Hematology, Ibni Sina Hospital, Ankara University, Ankara, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Ilhan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000069439:Dasatinib / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage* / Q000009:adverse effects; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D010349:Patient Compliance; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011743:Pyrimidines / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases; C498826:nilotinib; D000069439:Dasatinib
keywords: chronic myeloid leukemia; dasatinib; elderly patients; imatinib; nilotinib