Effects and outcome of a policy of intermittent imatinib treatment in elderly patients with chronic myeloid leukemia

Domenico Russo, Giovanni Martinelli, Michele Malagola, Cristina Skert, Simona Soverini, Ilaria Iacobucci, Antonio De Vivo, Nicoletta Testoni, Fausto Castagnetti, Gabriele Gugliotta, Diamante Turri, Michela Bergamaschi, Patrizia Pregno, Ester Pungolino, Fabio Stagno, Massimo Breccia, Bruno Martino, Tamara Intermesoli, Carmen Fava, Elisabetta Abruzzese, Mario Tiribelli, Catia Bigazzi, Bruno Mario Cesana, Gianantonio Rosti and Michele Baccarani
This article has an Erratum 123(18):2902

Key points

  • Intermittent imatinib treatment affects cytogenetic and molecular response, but not the outcome

  • No patients treated with INTERIM progressed to AP or BP


We report a study of an alternative treatment schedule of imatinib (IM) in chronic myeloid leukemia (CML). Seventy-six Philadelphia-positive (Ph+) - BCR-ABL - positive patients aged 65 years or older, who had been treated with IM for more than two years and who were in stable complete cytogenetic response (CCgR) and in major molecular response (MMR), were enrolled in a single-arm study to test the effects of a policy of intermittent imatinib (INTERIM) therapy, one month on and one month off. With a minimum follow-up of four years, 13 patients (17%) lost CCgR and MMR, and 14 (18 %) lost MMR only. All these patients resumed continuous imatinib, and all - but one (lost to follow-up) regained CCgR and MMR. No patients progressed to accelerated or blastic phase, or developed clonal chromosomal abnormalities in Ph+ cells, or BCR-ABL mutations. In elderly Ph+ CML patients carefully selected for a stable CCgR (lasting > 2 years), the policy of intermittent imatinib treatment affected the markers of residual disease, but not the clinical outcomes (overall and progression-free survival). number: NCT 00858806

  • Submitted January 28, 2013.
  • Accepted May 7, 2013.