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Frontline imatinib treatment of chronic myeloid leukemia: no impact of age on outcome, a survey by the GIMEMA CML WP

Gabriele Gugliotta, Fausto Castagnetti, Francesca Palandri, Massimo Breccia, Tamara Intermesoli, Adele Capucci, Bruno Martino, Patrizia Pregno, Serena Rupoli, Dario Ferrero, Filippo Gherlinzoni, Enrico Montefusco, Monica Bocchia, Mario Tiribelli, Ivana Pierri, Federica Grifoni, Giulia Marzocchi, Marilina Amabile, Nicoletta Testoni, Giovanni Martinelli, Giuliana Alimena, Fabrizio Pane, Giuseppe Saglio, Michele Baccarani, Gianantonio Rosti

Abstract

The median age of Chronic Myeloid Leukemia (CML) patients is around 60 years and age is still considered an important prognostic factor, included in Sokal and EURO risk scores. However, few data are available about the long term outcome of older patients treated with imatinib (IM) frontline. We analyzed the relationship between age and outcome in 559 early chronic phase (CP) CML patients, enrolled in 3 prospective clinical trials of GIMEMA CML-WP, treated frontline with IM, with a median follow-up of 60 months. Older patients (≥ 65 years old) were 115 (21%). The complete cytogenetic and major molecular response rates were similar in the two age groups. In older patients, event-free survival (55% vs. 67%), failure-free survival (78% vs. 92%), progression-free survival (62% vs. 78%), and overall survival (75% vs. 89%) were significantly inferior (all p<0.01) due to a higher proportion of deaths occurred in complete hematologic response, therefore unrelated to CML progression (15% vs. 3%, p<0.0001). The outcome was similar once those deaths were censored. These data show that response to IM was not affected by age and that the mortality rate linked to CML is similar in both age groups. (www.clinicaltrials.gov - NCT00514488 and NCT00510926)

  • Submitted December 15, 2010.
  • Accepted March 1, 2011.