Blood Journal
Leading the way in experimental and clinical research in hematology

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

  1. Gabriele Gugliotta1,
  2. Fausto Castagnetti1,
  3. Francesca Palandri1,
  4. Massimo Breccia2,
  5. Tamara Intermesoli3,
  6. Adele Capucci4,
  7. Bruno Martino5,
  8. Patrizia Pregno6,
  9. Serena Rupoli7,
  10. Dario Ferrero8,
  11. Filippo Gherlinzoni9,
  12. Enrico Montefusco10,
  13. Monica Bocchia11,
  14. Mario Tiribelli12,
  15. Ivana Pierri13,
  16. Federica Grifoni14,
  17. Giulia Marzocchi1,
  18. Marilina Amabile1,
  19. Nicoletta Testoni1,
  20. Giovanni Martinelli1,
  21. Giuliana Alimena2,
  22. Fabrizio Pane15,
  23. Giuseppe Saglio16,
  24. Michele Baccarani1, and
  25. Gianantonio Rosti1,*
  1. 1 Department of Hematolgy and Oncology Seragnoli, University of Bologna - S.Orsola-Malpighi Hospital, Bologna, Italy;
  2. 2 Department of Biotechnologies and Hematology, La Sapienza University, Rome, Italy;
  3. 3 Hematology Unit, Ospedali Riuniti, Bergamo, Italy;
  4. 4 Hematology Unit, Spedali Civili, Brescia, Italy;
  5. 5 Hematology Unit, Opsedali Riuniti, Reggio Calabria, Italy;
  6. 6 Hematology Unit, Maggiore Hospital, Turin, Italy;
  7. 7 Department of Hematology, University of Ancona, Ancona, Italy;
  8. 8 Department of Hematology, University of Turin - S.Giovanni Battista Hospital, Turin, Italy;
  9. 9 Hematology Unit, Ca' Foncello Hospital, Treviso, Italy;
  10. 10 Department of Hematology, La Sapienza University - S.Andrea Hospital, Rome, Italy;
  11. 11 Department of Hematology, University of Siena - Le Scotte Hospital, Siena, Italy;
  12. 12 Department of Hematology, University of Udine, Udine, Italy;
  13. 13 Department of Hematology, University of Genova, Genova, Italy;
  14. 14 Department of Hematology, University of Milan, Milan, Italy;
  15. 15 CEINGE and Department of Medical Biotechnologies, Federico II University, Naples, Italy;
  16. 16 Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
  1. * Corresponding author; email: totorosti{at}


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. ( - NCT00514488 and NCT00510926)

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