Clinical Results According to Age in Patients with Chronic Myeloid Leukemia Receiving Imatinib Frontline: the Younger, the Later, the Worse?

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<0.001 for CCyR and p=0.001 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=0.001]: no difference was observed for blastic evolution (p=0.478). Number of deaths was higher in the EL [12 (16.2%) vs 2 (3.2%) in YA and 0 in MA, p<0.001]: 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=0.02). The OS curve in EL was significantly shorter than in YA and in MA (p<0.001). 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.