Clinical results according to age in patients with chronic myeloid leukemia receiving imatinib frontline: The younger, the later, the worse?

Roberto Latagliata; Massimo Breccia; Ida Carmosino; Laura Cesini; Daniela De Benedittis; Sara Mohamed; Federico Vozella; Matteo Molica; Melissa Campanelli; Maria Lucia De Luca; Gioia Colafigli; Luisa Quattrocchi; Maria Giovanna Loglisci; Fulvio Massaro; Martina Canichella; Daniela Diverio; Marco Mancini; Giuliana Alimena; Robin Foà

doi:10.1111/ejh.13110

Clinical results according to age in patients with chronic myeloid leukemia receiving imatinib frontline: The younger, the later, the worse?

Eur J Haematol. 2018 Jun 13. doi: 10.1111/ejh.13110. Online ahead of print.

Authors

Roberto Latagliata¹, Massimo Breccia¹, Ida Carmosino¹, Laura Cesini¹, Daniela De Benedittis¹, Sara Mohamed¹, Federico Vozella¹, Matteo Molica¹, Melissa Campanelli¹, Maria Lucia De Luca¹, Gioia Colafigli¹, Luisa Quattrocchi¹, Maria Giovanna Loglisci¹, Fulvio Massaro¹, Martina Canichella¹, Daniela Diverio¹, Marco Mancini¹, Giuliana Alimena¹, Robin Foà¹

Affiliation

¹ Department of Cellular Biotechnologies and Hematology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.

PMID: 29896890
DOI: 10.1111/ejh.13110

Abstract

Objectives: To evaluate differences in clinical results according to age among patients with chronic myeloid leukemia (CML).

Methods: 207 consecutive CML patients treated with imatinib frontline were revised, dividing them in young adults (>20 < 45 years) (YA), middle-aged adults (≥45 < 65 years) (MA) and elderly (≥65 years) (EL).

Results: Cumulative incidence of complete cytogenetic response (CCyR) and major molecular response (MMolR) were significantly higher in MA compared with YA and EL (P < .001 for CCyR and P = .001 for MMolR). Number of total events was lower in MA (8 [11.1%] vs 21 [34.4%] in YA and 28 [37.8%] in EL, P = .001): no difference was observed for blastic evolution (P = .478). Number of deaths was higher in the EL (12 [16.2%] vs 2 [3.2%] in YA and 0 in MA, P < .001): however, 11/12 deaths in EL were not related to CML. The PFS curve in MA was significantly longer than in YA and in EL (P = .02). The OS curve in EL was significantly shorter than in YA and in MA (P < .001).

Conclusions: Age at diagnosis influences significantly the course of CML patients treated with imatinib: a possible explanation of the counterintuitive worse course in YA is the delayed diagnosis compared to elderly.

Keywords: chronic myeloid leukemia; elderly; imatinib; prognosis.