title: Switching to second-generation tyrosine kinase inhibitor improves the response and outcome of frontline imatinib-treated patients with chronic myeloid leukemia with more than 10% of BCR-ABL/ABL ratio at 3 months.
abstract: Chronic myeloid leukemia patients display heterogeneous responses to imatinib. Survival depends on baseline clinical characteristics (including prognostic scoring systems) and on early response (such as >10% BCR-ABL/ABL ratio at 3 months of therapy). The results of switching to second-generation tyrosine kinase inhibitors (2GTKIs) may contain a bias since, in the majority of these studies, patients who switch treatment due to intolerance or failure are censored or excluded. We analyzed the Spanish Registry data on switching in an intention-to-treat analysis of patients in standard clinical practice. Switching to 2GTKIs improves responses from 45% to 75% of complete cytogenetic response (CCyR) and from 15% to 45% of major molecular response (MMR) in the group without molecular response 1 (MR1) at 3 months and from 70% to 87% in CCyR and from 52% to 87% in MMR in the group with MR1. The final response rate is poorer in the group with no MR1 at 3 months. Nevertheless, the differences in the rates of response were not translated into differences in major events (transformations or deaths), and the final progression-free survival and overall survival were similar.
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Virgen de la Salud, Toledo, Spain.
authors.forename: Luis-Felipe
authors.initials: LF
authors.lastname: Casado
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: José-Valentín
authors.initials: JV
authors.lastname: García-Gutiérrez
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Valle de Hebrón, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Massagué
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Universitario Miguel Servet, Zaragoza, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Giraldo
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pérez-Encinas
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: de Paz
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Martínez-López
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Puerta de Hierro, Majadahonda, Spain.
authors.forename: Guiomar
authors.initials: G
authors.lastname: Bautista
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Osorio
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Universitario Severo Ochoa, Leganés, Spain.
authors.forename: María-José
authors.initials: MJ
authors.lastname: Requena
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Lozano Blesa, Zaragoza, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Palomera
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: María-Jesús
authors.initials: MJ
authors.lastname: Peñarrubia
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital General de Ciudad Real, Ciudad Real, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Calle
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Universitario Infanta Leonor, Madrid, Spain.
authors.forename: José-Ángel
authors.initials: JÁ
authors.lastname: Hernández-Rivas
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Burgaleta
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Maestro
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Virgen de la Salud, Toledo, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: García-Ormeña
authors.affiliation: Registro Español de Investigación y Tratamiento de Leucemia Mieloide Crónica (RELMC) [Spanish Registry for the Investigation and Treatment of Chronic Myeloid Leukemia], Madrid, Spain.|Servicio de Hematología y Hemoterapia, Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: Juan-Luis
authors.initials: JL
authors.lastname: Steegmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D057915:Drug Substitution; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000235:genetics*; D015972:Gene Expression Regulation, Neoplastic; D016313:Genes, abl; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000235:genetics* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D019233:Retreatment; D012189:Retrospective Studies; D013997:Time Factors; D014158:Transcription, Genetic; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D000068877:Imatinib Mesylate; D016044:Fusion Proteins, bcr-abl
keywords: BCR-ABL/ABL ratio; chronic myeloid leukemia; dasatinib; imatinib; nilotinib