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Annals of Hematology

, Volume 98, Issue 10, pp 2329–2338 | Cite as

Outcome of very elderly chronic myeloid leukaemia patients treated with imatinib frontline

  • Monica CrugnolaEmail author
  • Fausto Castagnetti
  • Massimo Breccia
  • Dario Ferrero
  • Malgorzata Monika Trawinska
  • Elisabetta Abruzzese
  • Mario Annunziata
  • Fabio Stagno
  • Mario Tiribelli
  • Gianni Binotto
  • Massimiliano Bonifacio
  • Carmen Fava
  • Alessandra Iurlo
  • Cristina Bucelli
  • Giovanna Mansueto
  • Antonella Gozzini
  • Franca Falzetti
  • Enrico Montefusco
  • Elena Crisà
  • Gabriele Gugliotta
  • Sabina Russo
  • Michele Cedrone
  • Antonella RussoRossi
  • Patrizia Pregno
  • Alessandro Isidori
  • Endri Mauro
  • Romano Atelda
  • Gianfranco Giglio
  • Francesca Celesti
  • Federica Sorà
  • Sergio Storti
  • Adam D’Addosio
  • Sara Galimberti
  • Ester Orlandi
  • Elisabetta Calistri
  • Monica Bocchia
  • Francesco Cavazzini
  • Giovanna Rege Cambrin
  • Nicola Orofino
  • Luigiana Luciano
  • Nicola Sgherza
  • Gianantonio Rosti
  • Roberto Latagliata
  • Isabella Capodanno
Original Article

Abstract

Very elderly (> 75 years) chronic myeloid leukaemia (CML) patients at diagnosis are sometimes treated with different doses of imatinib (IM) based on concomitant diseases and physicians’ judgement. However, data on long-term follow-up of these patients are still lacking. To investigate treatment response and outcome, we retrospectively revised an Italian database of 263 very elderly CML patients receiving IM from the time of diagnosis. Median age at diagnosis was 78.5 years and 56% of patients had 2 or 3 comorbidities. A complete haematological and cytogenetic response were achieved in 244 (92.8%) and 184 (69.9%) patients, respectively. In 148 cases (56.2%), a major molecular response was observed, which was deep in 63 cases (24%). A blastic phase occurred in 11 patients (4.2%). After a median follow-up of 45.0 months, 93 patients have died (9 from disease progression) and 104 (39.5%) are still in treatment with IM. Incidence of grades 3–4 haematological and non-haematological toxicity was similar to those reported in younger patients. Five-year event-free survival was 54.5% and 45.2% in patients ≤ 80 years and > 80 years, respectively (p = 0.098). Five years OS was 75.7% and 61.6% in patients ≤80 years and > 80 years, respectively (p = 0.003). These findings show that IM plays an important role in frontline treatment of very elderly CML patients without increased toxicity and any effort to treat these patients with standard doses should be made in order to achieve responses as in younger subjects.

Keywords

Chronic myeloid leukaemia Elderly Outcome Tyrosine kinase inhibitor 

Notes

Compliance with ethical standards

Monica Crugnola, Fausto Castagnetti, Massimo Breccia, Elisabetta Abruzzese, Gabriele Gugliotta, and Fabio Stagno declare that they received speaker honorarium from Novartis, BMS, Incyte, Pfizer, Amgen. Massimiliano Bonifacio declares research funding from Novartis and speakers honorarium from BMS, Incyte, Pfizer. No conflict of interest has been declared from other authors. All procedure performed in this study were in accordance with ethical standards and with the Helsinki declaration. Informed consent was obtained from all individual participants included in this study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Monica Crugnola
    • 1
    Email author
  • Fausto Castagnetti
    • 2
  • Massimo Breccia
    • 3
  • Dario Ferrero
    • 4
  • Malgorzata Monika Trawinska
    • 5
  • Elisabetta Abruzzese
    • 5
  • Mario Annunziata
    • 6
  • Fabio Stagno
    • 7
  • Mario Tiribelli
    • 8
  • Gianni Binotto
    • 9
  • Massimiliano Bonifacio
    • 10
  • Carmen Fava
    • 11
  • Alessandra Iurlo
    • 12
  • Cristina Bucelli
    • 12
  • Giovanna Mansueto
    • 13
  • Antonella Gozzini
    • 14
  • Franca Falzetti
    • 15
  • Enrico Montefusco
    • 16
  • Elena Crisà
    • 17
  • Gabriele Gugliotta
    • 2
  • Sabina Russo
    • 18
  • Michele Cedrone
    • 19
  • Antonella RussoRossi
    • 20
  • Patrizia Pregno
    • 21
  • Alessandro Isidori
    • 22
  • Endri Mauro
    • 23
  • Romano Atelda
    • 3
  • Gianfranco Giglio
    • 24
  • Francesca Celesti
    • 25
  • Federica Sorà
    • 26
  • Sergio Storti
    • 27
  • Adam D’Addosio
    • 28
  • Sara Galimberti
    • 29
  • Ester Orlandi
    • 30
  • Elisabetta Calistri
    • 31
  • Monica Bocchia
    • 32
  • Francesco Cavazzini
    • 33
  • Giovanna Rege Cambrin
    • 34
  • Nicola Orofino
    • 12
  • Luigiana Luciano
    • 35
  • Nicola Sgherza
    • 36
  • Gianantonio Rosti
    • 2
  • Roberto Latagliata
    • 3
  • Isabella Capodanno
    • 37
  1. 1.Hematology and BMT Center, “Azienda Ospedaliero-Universitaria di Parma,” Department Medicine and SurgeryUniversity of ParmaParmaItaly
  2. 2.Institute of Hematology “L and A Seragnoli,” Department of Experimental Hematology, Diagnostic and Speciality Medicine, S.Orsola MalpighiUniversity Hospital BolognaBolognaItaly
  3. 3.Department of Cellular Biotechnologies and HematologyUniversity “La Sapienza” of RomeRomeItaly
  4. 4.Hematology UnitUniversity of TurinTurinItaly
  5. 5.Hematology, S. Eugenio Hospital, Tor VergataUniversity of RomeRomeItaly
  6. 6.HematologyOspedale CardarelliNaplesItaly
  7. 7.HematologyOspedale FerrarottoCataniaItaly
  8. 8.Department of Medical Area University of UdineUdineItaly
  9. 9.Hematology UnitUniversity of PadovaPadovaItaly
  10. 10.Department of Medicine, Section of HematologyUniversity of VeronaVeronaItaly
  11. 11.Division of Hematology and Internal MedicineUniversity of Turin “San Luigi Gonzaga”TurinItaly
  12. 12.Oncohematology Division, IRCCS Ca’Granda-Maggiore Policlinico Hospital FoundationUniversity of MilanMilanItaly
  13. 13.Department of Onco-HematologyIRCS-CROBRionero in VoltureItaly
  14. 14.Hematology, AOU CareggiUniversity of FlorenceFlorenceItaly
  15. 15.Division of Hematology and Clinical Immunology, Department of MedicineUniversity of PerugiaPerugiaItaly
  16. 16.Hematology Unit Azienda Ospedaliero Universitaria Sant’AndreaRomeItaly
  17. 17.Haematology Division Università degli Studi di TorinoTurinItaly
  18. 18.Hematology UniversityMessinaItaly
  19. 19.Hematology UnitSan Giovanni HospitalRomeItaly
  20. 20.Hematology and Transplantation UnitUniversity of BariBariItaly
  21. 21.Hematology UnitAzienda Ospedaliero Universitaria Città della Salute e della ScienzaTurinItaly
  22. 22.Hematology UnitPesaro Hospital ItalyUrbinoItaly
  23. 23.Department of Internal MedicinePordenone General HospitalPordenoneItaly
  24. 24.Hematology UnitOspedale CivileCampobassoItaly
  25. 25.Hematology UnitOspedale BelcolleViterboItaly
  26. 26.Institute of HematologyUniversità Cattolica SacroCuoreRomeItaly
  27. 27.Oncohematology UnitUniversità Cattolica Giovanni Paolo IIRomeItaly
  28. 28.Immunohematology and Transfusional Medicine DivisionS. Pietro Fatebenefratelli HospitalRomeItaly
  29. 29.Department of Clinical and Experimental Medicine, Section of HematologyUniversity of Pisa ItalyPisaItaly
  30. 30.Hematology UnitIRCCS Policlinico San MatteoPaviaItaly
  31. 31.Hematology UnitTreviso HospitalTrevisoItaly
  32. 32.Hematology UnitAzienda Ospedaliero Universitaria Senese and University of SienaSienaItaly
  33. 33.Hematology UnitUniversity of FerraraFerraraItaly
  34. 34.Division of Hematology and Internal Medicine University of Turin“San Luigi Gonzaga” University HospitalOrbassanoItaly
  35. 35.Hematology Unit “Federico II Hospital”University of NaplesNaplesItaly
  36. 36.Hematology UnitIRCCS “Casa Sollievo della Sofferenza”San Giovanni RotondoItaly
  37. 37.Hematology UnitAzienda Unità Sanitaria Locale-IRCCSReggio EmiliaItaly

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