Does Time to Response Impact Outcomes in Accelerated-Phase CML?
Posted: Wednesday, September 2, 2020
Jorge E. Cortes, MD, of the Georgia Cancer Center, Augusta, and colleagues conducted a retrospective analysis to assess the impact of time to response on outcomes for patients with accelerated-phase chronic myeloid leukemia (CML) who were treated with tyrosine kinase inhibitors as initial therapy. The findings, which were published in the American Journal of Hematology, revealed that an early response at 3 and 6 months may be a strong determinant of long-term outcomes for these patients.
“Patients with features of the accelerated phase at the time of CML diagnosis have excellent outcomes when treated with tyrosine kinase inhibitors as initial therapy, particularly with second-generation tyrosine kinase inhibitors,” the investigators remarked. “The outcomes for patients with similar favorable responses at early time points are similar regardless of the tyrosine kinase inhibitor used.”
Using clinical data from September 1999 through November 2016, the investigators analyzed 75 patients with confirmed de novo accelerated-phase CML who received tyrosine kinase inhibitors as initial therapy. A total of 33 patients were treated with imatinib. Among the 42 patients who were administered a second-generation tyrosine kinase inhibitor as initial therapy, 19 received dasatinib, and 23 received nilotinib. Follow-up data were available for an average of 96 months.
The overall rates of complete cytogenetic, major molecular, and molecular responses were 79%, 71%, and 59%, respectively. The 49 patients who had a major cytogenetic response at 3 months seemed to have significantly better 3-year overall survival (94% vs. 75%; P = .002), transformation-free survival (98% vs. 73%; P < .001), event-free survival (93% vs. 42%; P < .001), and failure-free survival (83% vs. 25%; P < .001) rates than those who did not achieve these responses. Of the patients who eventually achieved sustained molecular response 4.5, 67% achieved a major cytogenetic response at 3 months.
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.