BACKGROUND: The European LeukemiaNet recommendations for chronic myeloid leukemia (CML) defined a group of patients with suboptimal response to imatinib. The significance of this response was not well defined. METHODS: The significance of having had a suboptimal response during imatinib therapy among 281 patients with CML treated with standard-dose (n = 73) or high-dose (n = 208) imatinib was investigated. RESULTS: Rates of suboptimal response at 6, 12, and 18 months were 4%, 8%, and 40%, respectively, and were not influenced by Sokal risk score. Patients with a suboptimal response at 6 months had a significantly lower probability of eventually achieving a complete cytogenetic response (CCyR) compared with those with an optimal response (30% vs 97%; P < .001), and their event-free survival (EFS) and transformation-free survival (TFS) were found to be similar to those with criteria for failure at this time point. Suboptimal response at 12 months defined a group with a similar TFS as those with optimal response, but with worse EFS. In contrast, patients with a suboptimal response at 18 months had outcomes that were similar to those patients with an optimal response. A multivariate analysis confirmed the significance of response category after adjusting for pretreatment characteristics and imatinib dose. CONCLUSIONS: The results of the current study suggested that suboptimal response was a heterogeneous category, and some patients had an outcome that mirrored that of patients with failed therapy. Interventions aimed at improving this outcome are required.
BACKGROUND: The European LeukemiaNet recommendations for chronic myeloid leukemia (CML) defined a group of patients with suboptimal response to imatinib. The significance of this response was not well defined. METHODS: The significance of having had a suboptimal response during imatinib therapy among 281 patients with CML treated with standard-dose (n = 73) or high-dose (n = 208) imatinib was investigated. RESULTS: Rates of suboptimal response at 6, 12, and 18 months were 4%, 8%, and 40%, respectively, and were not influenced by Sokal risk score. Patients with a suboptimal response at 6 months had a significantly lower probability of eventually achieving a complete cytogenetic response (CCyR) compared with those with an optimal response (30% vs 97%; P < .001), and their event-free survival (EFS) and transformation-free survival (TFS) were found to be similar to those with criteria for failure at this time point. Suboptimal response at 12 months defined a group with a similar TFS as those with optimal response, but with worse EFS. In contrast, patients with a suboptimal response at 18 months had outcomes that were similar to those patients with an optimal response. A multivariate analysis confirmed the significance of response category after adjusting for pretreatment characteristics and imatinib dose. CONCLUSIONS: The results of the current study suggested that suboptimal response was a heterogeneous category, and some patients had an outcome that mirrored that of patients with failed therapy. Interventions aimed at improving this outcome are required.
Authors: Jorge Cortes; Moshe Talpaz; Susan O'Brien; Dan Jones; Rajyalakshmi Luthra; Jenny Shan; Francis Giles; Stefan Faderl; Srdan Verstovsek; Guillermo Garcia-Manero; Mary B Rios; Hagop Kantarjian Journal: Clin Cancer Res Date: 2005-05-01 Impact factor: 12.531
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: A Hochhaus; M Baccarani; M Deininger; J F Apperley; J H Lipton; S L Goldberg; S Corm; N P Shah; F Cervantes; R T Silver; D Niederwieser; R M Stone; H Dombret; R A Larson; L Roy; T Hughes; M C Müller; R Ezzeddine; A M Countouriotis; H M Kantarjian Journal: Leukemia Date: 2008-04-10 Impact factor: 11.528
Authors: David Marin; Dragana Milojkovic; Eduardo Olavarria; Jamshid S Khorashad; Hugues de Lavallade; Alistair G Reid; Letizia Foroni; Katayoun Rezvani; Marco Bua; Francesco Dazzi; Jiri Pavlu; Matthias Klammer; Jaspal S Kaeda; John M Goldman; Jane F Apperley Journal: Blood Date: 2008-08-20 Impact factor: 22.113
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
Authors: Rüdiger Hehlmann; David Grimwade; Bengt Simonsson; Jane Apperley; Michele Baccarani; Tiziano Barbui; Giovanni Barosi; Renato Bassan; Marie C Béné; Ute Berger; Thomas Büchner; Alan Burnett; Nicolas C P Cross; Theo J M de Witte; Hartmut Döhner; Hervé Dombret; Hermann Einsele; Georg Engelich; Robin Foà; Christa Fonatsch; Nicola Gökbuget; Elaine Gluckman; Alois Gratwohl; Francois Guilhot; Claudia Haferlach; Thorsten Haferlach; Michael Hallek; Jörg Hasford; Andreas Hochhaus; Dieter Hoelzer; Jean-Jaques Kiladjian; Boris Labar; Per Ljungman; Ulrich Mansmann; Dietger Niederwieser; Gert Ossenkoppele; José M Ribera; Harald Rieder; Hubert Serve; Petra Schrotz-King; Miguel A Sanz; Susanne Saussele Journal: Haematologica Date: 2010-11-03 Impact factor: 9.941
Authors: Edgar Faber; David Friedecký; Katerina Micová; Martina Divoká; Beata Katrincsáková; Sárka Rozmanová; Marie Jarosová; Karel Indrák; Tomás Adam Journal: Int J Hematol Date: 2010-05-01 Impact factor: 2.490