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What happens to intolerant, relapsed or refractory chronic myeloid leukemia patients without access to clinical trials?
Bosi, Guilherme Rasia; Fogliatto, Laura Maria; Costa, Tito Emilio Vanelli; Grokoski, Kamila Castro; Pereira, Mariana Pinto; Bugs, Nathan; Kalil, Marco; Fraga, Christina; Daudt, Liane Esteves; Silla, Lucia Mariano da Rocha.
  • Bosi, Guilherme Rasia; Universidade Federal do Rio Grande do Sul - UFRGS. Porto Alegre. BR
  • Fogliatto, Laura Maria; Universidade Federal do Rio Grande do Sul - UFRGS. Porto Alegre. BR
  • Costa, Tito Emilio Vanelli; Universidade Federal do Rio Grande do Sul - UFRGS. Porto Alegre. BR
  • Grokoski, Kamila Castro; Universidade Federal do Rio Grande do Sul - UFRGS. Porto Alegre. BR
  • Pereira, Mariana Pinto; Universidade Federal do Rio Grande do Sul - UFRGS. Porto Alegre. BR
  • Bugs, Nathan; Universidade Federal do Rio Grande do Sul - UFRGS. Porto Alegre. BR
  • Kalil, Marco; Universidade Federal do Rio Grande do Sul - UFRGS. Porto Alegre. BR
  • Fraga, Christina; Universidade Federal do Rio Grande do Sul - UFRGS. Porto Alegre. BR
  • Daudt, Liane Esteves; Universidade Federal do Rio Grande do Sul - UFRGS. Porto Alegre. BR
  • Silla, Lucia Mariano da Rocha; Universidade Federal do Rio Grande do Sul - UFRGS. Porto Alegre. BR
Hematol., Transfus. Cell Ther. (Impr.) ; 41(3): 222-228, July-Sept. 2019. tab, graf, ilus
Article in English | LILACS | ID: biblio-1039921
ABSTRACT
ABSTRACT

Objective:

To assess clinical outcomes of intolerant, relapsed or refractory patients who could not be treated with new tyrosine kinase inhibitors or experimental therapies.

Methods:

A retrospective cohort of 90 chronic myeloid leukemia patients in all phases of the disease treated with imatinib mesylate as their first TKI therapy, and with dasatinib or nilotinib as the next line of therapy. We evaluated clinical outcomes of these patients, with special focus on the group that needed more than two therapy lines.

Results:

Thirty-nine percent of patients were refractory or intolerant to imatinib. An 8-year overall survival rate of the patients who went through three or more lines of treatment was significantly lower, compared to those who were able to maintain imatinib as their first-line therapy (83% and 22%, respectively p < 0.01). Decreased overall survival was associated with advanced-phase disease (p < 0.01), failure to achieve major molecular response in first-line treatment (p < 0.01) and interruption of first-line treatment due to any reason (p = 0.023). Failure in achieving complete cytogenetic response and major molecular response and treatment interruption were associated with the progression to the third-line treatment.

Conclusion:

The critical outcome observed in relapsed, intolerant or refractory chronic phase CML patients reflects the unmet need for this group of patients without an alternative therapy, such as new drugs or experimental therapies in clinical trials. Broader access to newer treatment possibilities is a crucial asset to improve survival among CML patients, especially those refractory or intolerant to first-line therapies.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Survival Analysis / Imatinib Mesylate / Dasatinib Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: English Journal: Hematol., Transfus. Cell Ther. (Impr.) Journal subject: Hematologia / TransfusÆo de Sangue Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal do Rio Grande do Sul - UFRGS/BR

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Full text: Available Index: LILACS (Americas) Main subject: Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Survival Analysis / Imatinib Mesylate / Dasatinib Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: English Journal: Hematol., Transfus. Cell Ther. (Impr.) Journal subject: Hematologia / TransfusÆo de Sangue Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal do Rio Grande do Sul - UFRGS/BR