title: Managing chronic myeloid leukaemia in the elderly with intermittent imatinib treatment.
abstract: The aim of this study was to investigate the effects of a non-standard, intermittent imatinib treatment in elderly patients with Philadelphia-positive chronic myeloid leukaemia and to answer the question on which dose should be used once a stable optimal response has been achieved. Seventy-six patients aged ⩾65 years in optimal and stable response with ⩾2 years of standard imatinib treatment were enrolled in a study testing a regimen of intermittent imatinib (INTERIM; 1-month on and 1-month off). With a minimum follow-up of 6 years, 16/76 patients (21%) have lost complete cytogenetic response (CCyR) and major molecular response (MMR), and 16 patients (21%) have lost MMR only. All these patients were given imatinib again, the same dose, on the standard schedule and achieved again CCyR and MMR or an even deeper molecular response. The probability of remaining on INTERIM at 6 years was 48% (95% confidence interval 35-59%). Nine patients died in remission. No progressions were recorded. Side effects of continuous treatment were reduced by 50%. In optimal and stable responders, a policy of intermittent imatinib treatment is feasible, is successful in about 50% of patients and is safe, as all the patients who relapsed could be brought back to optimal response.
authors.affiliation: Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Russo
authors.affiliation: Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Malagola
authors.affiliation: Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Skert
authors.affiliation: Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Cancelli
authors.affiliation: Ematologia 1-TMO, AOR Villa Sofia-Cervello, Palermo, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Turri
authors.affiliation: S.C. Ematologia, Dipartimento di Oncologia ed Ematologia, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Pregno
authors.affiliation: Dipartimento di Terapie Oncologiche Integrate, IRCCS AOU S. Martino-IST, Genova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bergamaschi
authors.affiliation: Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Fogli
authors.affiliation: Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Testoni
authors.affiliation: Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: De Vivo
authors.affiliation: Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Castagnetti
authors.affiliation: Division of Hematology, Department of Oncology and Hematology, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Pungolino
authors.affiliation: Divisione Clinicizzata di Ematologia AOU Policlinico-V. Emanuele, University of Catania, Catania, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Stagno
authors.affiliation: Azienda Policlinico Umberto I, Sapienza Università, Roma, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Breccia
authors.affiliation: Hematology Unit, 'Bianchi-Melacrino-Morelli' Hospital, Reggio Calabria, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Martino
authors.affiliation: Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Intermesoli
authors.affiliation: University of Turin, San Luigi Gonzaga Hospital, Turin, Italy.
authors.forename: G R
authors.initials: GR
authors.lastname: Cambrin
authors.affiliation: Hematology and Hematopoietic Stem Cell Transplant Center, San Salvatore Hospital, Pesaro, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Nicolini
authors.affiliation: Hematology, S Eugenio Hospital Tor Vergata University, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Abruzzese
authors.affiliation: Division of Hematology and BMT, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tiribelli
authors.affiliation: Hematology, Mazzoni Hospital, Ascoli Piceno, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bigazzi
authors.affiliation: U O Ematologia e CTMO Ospedale A., Businco-Cagliari, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Usala
authors.affiliation: UOC Ematologia AOU 'G Martino' Policlinico Universitario di Messina, Messina, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Russo
authors.affiliation: Division of Hematology, University of Bari, Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Russo-Rossi
authors.affiliation: Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Lunghi
authors.affiliation: Hematology and Transplants, University of Siena and AOUS, Siena, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bocchia
authors.affiliation: Department of Cellular Therapies and Haematology, San Bortolo Hospital, Vicenza, Italy.
authors.forename: A
authors.initials: A
authors.lastname: D'Emilio
authors.affiliation: Unità di Ematologia, AOU Careggi, University of Florence, Florence, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Santini
authors.affiliation: Hematology Department, 'A. Perrino' Hospital, Brindisi, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Girasoli
authors.affiliation: Division of Haematology, Spirito Santo Hospital, Pescara, Italy.
authors.forename: R Di
authors.initials: RD
authors.lastname: Lorenzo
authors.affiliation: Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bernardi
authors.affiliation: Unit of Blood Diseases and Stem Cell Transplantation, University of Brescia, Brescia, Italy.
authors.forename: A Di
authors.initials: AD
authors.lastname: Palma
authors.affiliation: DMMT, Unit of Medical Statistics, University of Brescia, Brescia, Italy.
authors.forename: B M
authors.initials: BM
authors.lastname: Cesana
authors.affiliation: Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Soverini
authors.affiliation: Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Martinelli
authors.affiliation: Institute of Hematology 'L. & A. Seràgnoli', DIMES, University of Bologna, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rosti
authors.affiliation: Department of Haematology-Oncology 'L. and A. Seràgnoli' - S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Baccarani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate / Q000008:administration & dosage* / Q000009:adverse effects; D017404:In Situ Hybridization, Fluorescence; D053208:Kaplan-Meier Estimate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D010865:Pilot Projects; D012074:Remission Induction / Q000379:methods
chemical_list: D000970:Antineoplastic Agents; D000068877:Imatinib Mesylate