Background: In elderly patients with chronic myeloid leukemia (CML) responsive to imatinib, the incidence of clinically significant (CS) late chronic anemia is still unknown. Materials and Methods: To highlight this issue, we revised retrospectively 81 CML patients aged >60 years treated at our Institution with front-line imatinib for at least 24 months in durable complete cytogenetic response (CCyR). CS late chronic anemia was defined as the presence of persistent (>6 months) and otherwise unexplained Hb levels <= 10 g/dL, which occurred >6 months from imatinib start. Results: A condition of CS late chronic anemia occurred in 22 out of 81 patients (27.2\%) at different intervals from imatinib start. Seven out of 22 patients (31.8\%) needed packed red cell transfusions during the follow-up. At diagnosis, patients who developed CS late chronic anemia were significantly older and had a lower Hb median level. Six out of 22 patients with CS late chronic anemia received subcutaneous recombinant alpha-erythropoietin (EPO) at the standard dosage of 40,000 IU weekly: all 6 patients achieved an erythroid response. A significantly worse event-free survival (EFS) in patients with untreated CS late chronic anemia was observed (p = 0.012). Conclusions: CS late chronic anemia during long-term treatment with imatinib is a common complication in responsive elderly patients, with worse EFS if untreated. Results with EPO are encouraging, but larger studies are warranted to define its role.
Incidence of Clinically Significant (<= 10 g/dL) Late Anemia in Elderly Patients with Newly Diagnosed Chronic Myeloid Leukemia Treated with Imatinib / Cesini, L., Carmosino, I., Breccia, M., De Benedittis, D., Mohamed, S., DE LUCA, M.L., Colafigli, G., Molica, M., Scalzulli, E., Massaro, F., Mariggiò, E., Rizzo, L., Loglisci, M.G., Scamuffa, M.C., Vozella, F., Diverio, D., Mancini, M., Alimena, G., Robin, F., Latagliata, R.. - In: ONCOLOGY RESEARCH AND TREATMENT. - ISSN 2296-5262. - 42:12(2019), pp. 660-664. [10.1159/000502801]
Incidence of Clinically Significant (<= 10 g/dL) Late Anemia in Elderly Patients with Newly Diagnosed Chronic Myeloid Leukemia Treated with Imatinib
Laura Cesini;Ida Carmosino;Massimo Breccia;Sara Mohamed;Maria Lucia De Luca;Gioia Colafigli;Matteo Molica;Emilia Scalzulli;Fulvio Massaro;Lorenzo Rizzo;Maria Giovanna Loglisci;Maria Cristina Scamuffa;Federico Vozella;Marco Mancini;Giuliana Alimena;Robin Foà;
2019
Abstract
Background: In elderly patients with chronic myeloid leukemia (CML) responsive to imatinib, the incidence of clinically significant (CS) late chronic anemia is still unknown. Materials and Methods: To highlight this issue, we revised retrospectively 81 CML patients aged >60 years treated at our Institution with front-line imatinib for at least 24 months in durable complete cytogenetic response (CCyR). CS late chronic anemia was defined as the presence of persistent (>6 months) and otherwise unexplained Hb levels <= 10 g/dL, which occurred >6 months from imatinib start. Results: A condition of CS late chronic anemia occurred in 22 out of 81 patients (27.2\%) at different intervals from imatinib start. Seven out of 22 patients (31.8\%) needed packed red cell transfusions during the follow-up. At diagnosis, patients who developed CS late chronic anemia were significantly older and had a lower Hb median level. Six out of 22 patients with CS late chronic anemia received subcutaneous recombinant alpha-erythropoietin (EPO) at the standard dosage of 40,000 IU weekly: all 6 patients achieved an erythroid response. A significantly worse event-free survival (EFS) in patients with untreated CS late chronic anemia was observed (p = 0.012). Conclusions: CS late chronic anemia during long-term treatment with imatinib is a common complication in responsive elderly patients, with worse EFS if untreated. Results with EPO are encouraging, but larger studies are warranted to define its role.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
