Ten-year outcome of chronic-phase chronic myeloid leukemia patients treated with imatinib in real life

Imatinib, the first BCR/ABL kinase inhibitor approved for the treatment of chronic myeloid leukemia (CML), has changed the long-term outcome of patients affected by this disease. The aim of our analysis was to report, after a median follow-up of 10.2years (range 5.8-14.8), the long-term outcome, efficacy, and safety of imatinib treatment (frontline and after interferon failure) in a single institution cohort of 459 patients with CML in chronic phase treated outside of clinical trials. The 10-year overall survival of the whole cohort was 77.1\%, while the 10-year probability of dying due to CML and other causes was 7.8\% and 16\%, respectively. The prognostic value of the BCR-ABL1 ratio at 3months (10\%) and of complete cytogenetic response and major molecular response at 1year was confirmed also in the real-life practice. The EUTOS long-term survival score better stratified the baseline risk of dying of CML compared with other risk scores. Two hundred thirty-six (51.4\%) patients achieved a deep molecular response during imatinib treatment after a median time of 4.57years, and 95 (20.6\%) had a stable deep molecular response maintained for at least 2 consecutive years. Imatinib was associated with a low rate of serious cardiovascular events and second neoplasia. This 10-year real-life follow-up study shows that imatinib maintains efficacy over time and that long-term administration of imatinib is not associated with notable cumulative or late toxic effects.