BACKGROUND: Imatinib mesylate given orally at a daily dose of 400 mg is the standard of care as initial therapy for patients with chronic myeloid leukemia (CML) in chronic phase (CML-CP). Treatment guidelines propose dose escalation based on clinical assessments of disease response. METHODS: Response and survival were analyzed in a cohort of patients (n = 106) with newly diagnosed CML-CP who were enrolled on the International Randomized Study of Interferon and STI571 (IRIS) trial, who began treatment with imatinib at a dose of 400 mg daily, and who subsequently underwent dose escalation to either 600 mg or 800 mg daily. Reasons for dose escalation were evaluated retrospectively based on 2 sets of criteria: the IRIS protocol-defined criteria (n = 39 patients) and the European LeukemiaNet (ELN) recommendations (n = 48 patients). RESULTS: Among all 106 patients who underwent dose escalation, the rates of freedom from progression to accelerated phase or blast phase and overall survival were 89% and 84% at 3 years after dose increase, respectively. A cytogenetic response was obtained in 42% of patients who had their dose escalated based on protocol criteria and in 38% of patients who had their dose escalated according to the ELN recommendations. CONCLUSIONS: The results from this retrospective analysis supported imatinib dose escalation as an appropriate initial option for patients with CML-CP who were experiencing suboptimal cytogenetic response or resistance. (c) 2008 American Cancer Society.
BACKGROUND:Imatinib mesylate given orally at a daily dose of 400 mg is the standard of care as initial therapy for patients with chronic myeloid leukemia (CML) in chronic phase (CML-CP). Treatment guidelines propose dose escalation based on clinical assessments of disease response. METHODS: Response and survival were analyzed in a cohort of patients (n = 106) with newly diagnosed CML-CP who were enrolled on the International Randomized Study of Interferon and STI571 (IRIS) trial, who began treatment with imatinib at a dose of 400 mg daily, and who subsequently underwent dose escalation to either 600 mg or 800 mg daily. Reasons for dose escalation were evaluated retrospectively based on 2 sets of criteria: the IRIS protocol-defined criteria (n = 39 patients) and the European LeukemiaNet (ELN) recommendations (n = 48 patients). RESULTS: Among all 106 patients who underwent dose escalation, the rates of freedom from progression to accelerated phase or blast phase and overall survival were 89% and 84% at 3 years after dose increase, respectively. A cytogenetic response was obtained in 42% of patients who had their dose escalated based on protocol criteria and in 38% of patients who had their dose escalated according to the ELN recommendations. CONCLUSIONS: The results from this retrospective analysis supported imatinib dose escalation as an appropriate initial option for patients with CML-CP who were experiencing suboptimal cytogenetic response or resistance. (c) 2008 American Cancer Society.
Authors: Andreas Hochhaus; Hagop M Kantarjian; Michele Baccarani; Jeffrey H Lipton; Jane F Apperley; Brian J Druker; Thierry Facon; Stuart L Goldberg; Francisco Cervantes; Dietger Niederwieser; Richard T Silver; Richard M Stone; Timothy P Hughes; Martin C Muller; Rana Ezzeddine; Athena M Countouriotis; Neil P Shah Journal: Blood Date: 2006-11-30 Impact factor: 22.113
Authors: Michele Baccarani; Giuseppe Saglio; John Goldman; Andreas Hochhaus; Bengt Simonsson; Frederick Appelbaum; Jane Apperley; Francisco Cervantes; Jorge Cortes; Michael Deininger; Alois Gratwohl; François Guilhot; Mary Horowitz; Timothy Hughes; Hagop Kantarjian; Richard Larson; Dietger Niederwieser; Richard Silver; Rudiger Hehlmann Journal: Blood Date: 2006-05-18 Impact factor: 22.113
Authors: Brian J Druker; François Guilhot; Stephen G O'Brien; Insa Gathmann; Hagop Kantarjian; Norbert Gattermann; Michael W N Deininger; Richard T Silver; John M Goldman; Richard M Stone; Francisco Cervantes; Andreas Hochhaus; Bayard L Powell; Janice L Gabrilove; Philippe Rousselot; Josy Reiffers; Jan J Cornelissen; Timothy Hughes; Hermine Agis; Thomas Fischer; Gregor Verhoef; John Shepherd; Giuseppe Saglio; Alois Gratwohl; Johan L Nielsen; Jerald P Radich; Bengt Simonsson; Kerry Taylor; Michele Baccarani; Charlene So; Laurie Letvak; Richard A Larson Journal: N Engl J Med Date: 2006-12-07 Impact factor: 91.245
Authors: Jeffrey A Zonder; Pamela Pemberton; Helen Brandt; Anwar N Mohamed; Charles A Schiffer Journal: Clin Cancer Res Date: 2003-06 Impact factor: 12.531
Authors: Hagop M Kantarjian; Francis Giles; Norbert Gattermann; Kapil Bhalla; Giuliana Alimena; Francesca Palandri; Gert J Ossenkoppele; Franck-Emmanuel Nicolini; Stephen G O'Brien; Mark Litzow; Ravi Bhatia; Francisco Cervantes; Ariful Haque; Yaping Shou; Debra J Resta; Aaron Weitzman; Andreas Hochhaus; Philipp le Coutre Journal: Blood Date: 2007-08-22 Impact factor: 22.113