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The achievement of an early complete cytogenetic response is a major determinant for outcome in patients with early chronic phase chronic myeloid leukemia treated with tyrosine kinase inhibitors

Elias Jabbour, Hagop Kantarjian, Susan O'Brien, Jenny Shan, Alfonso Quintas-Cardama, Stefan Faderl, Guillermo Garcia-Manero, Farhad Ravandi, Mary Beth Rios and Jorge Cortes

Article Figures & Data

Figures

  • Figure 1

    Outcome by CCyR at 6 and 12 months. (A) EFS by CCyR at 6 months. (B) OS by CCyR at 6 months. (C) EFS by CCyR at 12 months. (D) OS by CCyR at 12 months.

  • Figure 2

    Outcomes by CCyR and therapy. (A) EFS by therapy among patients with CCyR at 6 months. (B) OS by therapy among patients with CCyR at 6 months. (C) EFS by therapy among patients with CCyR at 12 months. (D) OS by therapy among patients with CCyR at 12 months. (E) Transformation-free survival by therapy (intent-to-treat analysis). (F) Transformation-free survival by therapy among patients with CCyR at 12 months.

  • Figure 3

    Outcomes by CCyR and NMR. (A) EFS by molecular response among patients with CCyR at 12 months. (B) OS by molecular response among patients with CCyR at 12 months.

Tables

  • Table 1

    Patient characteristics

    ParameterIM 400 mgIM 800 mgSecond TKIP
    No. of patients treated73208154
    Median age, y (range)48 (15-78)48 (17-84)47 (18-85).48
    Prior cytoreduction, %51 (73)95 (46)60 (39).0001
    Splenomegaly, %16 (22)59 (28)41 (27).56
    Hemoglobin, g/dL, < 12.0, no. (%)27 (37)82 (39)71 (46).32
    WBCs, × 109/L, ≥ 10, no. (%)55 (75)178 (86)112 (73).01
    Platelets, × 109/L, > 450, no. (%)22 (30)68 (33)43 (28).62
    Peripheral blast, %, any, no. (%)18 (25)76 (36)43 (28).09
    Peripheral basophils, %, ≥ 5, no. (%)15 (21)60 (29)39 (25).43
    Marrow blast, %, ≥ 5, no. (%)3 (4)18 (9)9 (6).40
    Marrow basophils, %, ≥ 5, no. (%)7 (10)32 (15)13 (8).11
    Sokal risk, no. (%)
        Low50 (68)132 (63)118 (77).02
        Intermediate22 (30)57 (27)27 (18)
        High1 (2)19 (9)9 (6)
    Ph+ > 90%, %67/72 (93)195 (94)133 (86).04
    Clonal evolution, %2 (3)7 (3)11/151 (7).15
    • IM indicates imatinib; and WBCs, white blood cells.

  • Table 2

    CCyR at 3, 6, and 12 months by therapy

    3 months6 months12 months
    EvaluableCCyR%PEvaluableCCyR%PEvaluableCCyR%P
    IM 400 mg702739703753684566
    IM 800 mg19912563< .00119416485< .00118716990< .001
    Second TKI141114811311259511811698
    • Evaluable indicates patients who received therapy and were evaluable for cytogenetic response at each time point; and IM, imatinib.

  • Table 3

    Outcome

    3-month CCyR6-month CCyR12-month CCyR
    YesNoPYesNoPYesNoP
    Total group
        3-year EFS9883< .0019772< .0019867< .001
        3-year OS9995.069990< .0019994< .001
    IM 400 mg
        3-year EFS9281.129774.0019872< .001
        3-year OS10088.04610087.0910088.046
    IM 800 mg
        3-year EFS9784.0059768< .0019858< .001
        3-year OS9897.939992.00199100.03
    Second TKI
        3-year EFS10080< .0019967< .00199NANA
        3-year OS100100NA100100NA100NANA
    P (EFS/OS).07/.3.56/.81.9/.6
    • IM indicates imatinib; and NA, not applicable