Long-term outcomes of frontline imatinib therapy for chronic myeloid leukemia in China

BackgroundImatinib is the first-line therapy recommended for chronic myeloid leukemia (CML) patients in China. We reported a long-term follow-up study of patients on imatinib as first-line treatment for chronic phase (CP) CML to provide an important reference for the actual clinical treatment regime...

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Main Authors: Fang Cheng, Guolin Yuan, Qiang Li, Zheng Cui, Weiming Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-05-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2023.1172910/full
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author Fang Cheng
Fang Cheng
Fang Cheng
Guolin Yuan
Qiang Li
Qiang Li
Zheng Cui
Zheng Cui
Weiming Li
author_facet Fang Cheng
Fang Cheng
Fang Cheng
Guolin Yuan
Qiang Li
Qiang Li
Zheng Cui
Zheng Cui
Weiming Li
author_sort Fang Cheng
collection DOAJ
description BackgroundImatinib is the first-line therapy recommended for chronic myeloid leukemia (CML) patients in China. We reported a long-term follow-up study of patients on imatinib as first-line treatment for chronic phase (CP) CML to provide an important reference for the actual clinical treatment regimen of CML patients in China.MethodsWe evaluated the long-term efficacy, safety, low-dose attempt after years of treatment, and treatment-free remission (TFR) of 237 CML-CP patients receiving first-line imatinib therapy.ResultsThe median age was 46 years (interquartile range: 33–55). After a median follow-up of 6.5 years, the cumulative complete cytogenetic response, major molecular response (MMR), and MR4.5 rates were 82.6%, 80.4%, and 69.3%, respectively. The 10-year transformation-free, event-free, and failure-free survival rates were 97.3%, 87.2% and 53.5%, respectively. Fifty-two (21.9%) patients with sustained deep molecular response (DMR) were treated with low-dose imatinib after years of imatinib treatment. No significant differences in the 1-year and 2-year molecular relapse-free survival in MMR and MR4 were observed between the standard-dose and low-dose groups. Twenty-eight (11.8%) patients discontinued imatinib, and the median time to maintain DMR before discontinuation was 8.43 years. Thirteen patients (5.5%) remained in TFR for a median of 43.33 months. No patients transformed to accelerate or blast phase or died. No new, late toxicity was observed, and the most frequent grade 3/4 adverse events were neutropenia (9.3%), anemia (7.6%), thrombocytopenia (6.3%), and rash (4.2%).ConclusionThis study confirmed the long-term efficacy and safety of imatinib for treating Chinese CML patients. Additionally, it demonstrated the feasibility of imatinib dose reduction and TFR attempts in patients with sustained stable DMR after years of imatinib treatment in real-life settings.
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spelling doaj.art-26f70348d62244abae443a081a8e99572023-05-02T05:12:11ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11729101172910Long-term outcomes of frontline imatinib therapy for chronic myeloid leukemia in ChinaFang Cheng0Fang Cheng1Fang Cheng2Guolin Yuan3Qiang Li4Qiang Li5Zheng Cui6Zheng Cui7Weiming Li8Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, ChinaHubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Hematology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Hubei, ChinaDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, ChinaDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, ChinaDepartment of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaBackgroundImatinib is the first-line therapy recommended for chronic myeloid leukemia (CML) patients in China. We reported a long-term follow-up study of patients on imatinib as first-line treatment for chronic phase (CP) CML to provide an important reference for the actual clinical treatment regimen of CML patients in China.MethodsWe evaluated the long-term efficacy, safety, low-dose attempt after years of treatment, and treatment-free remission (TFR) of 237 CML-CP patients receiving first-line imatinib therapy.ResultsThe median age was 46 years (interquartile range: 33–55). After a median follow-up of 6.5 years, the cumulative complete cytogenetic response, major molecular response (MMR), and MR4.5 rates were 82.6%, 80.4%, and 69.3%, respectively. The 10-year transformation-free, event-free, and failure-free survival rates were 97.3%, 87.2% and 53.5%, respectively. Fifty-two (21.9%) patients with sustained deep molecular response (DMR) were treated with low-dose imatinib after years of imatinib treatment. No significant differences in the 1-year and 2-year molecular relapse-free survival in MMR and MR4 were observed between the standard-dose and low-dose groups. Twenty-eight (11.8%) patients discontinued imatinib, and the median time to maintain DMR before discontinuation was 8.43 years. Thirteen patients (5.5%) remained in TFR for a median of 43.33 months. No patients transformed to accelerate or blast phase or died. No new, late toxicity was observed, and the most frequent grade 3/4 adverse events were neutropenia (9.3%), anemia (7.6%), thrombocytopenia (6.3%), and rash (4.2%).ConclusionThis study confirmed the long-term efficacy and safety of imatinib for treating Chinese CML patients. Additionally, it demonstrated the feasibility of imatinib dose reduction and TFR attempts in patients with sustained stable DMR after years of imatinib treatment in real-life settings.https://www.frontiersin.org/articles/10.3389/fonc.2023.1172910/fullimatinibchromic myeloid leukemiapharmacotherapyefficacydrug safety
spellingShingle Fang Cheng
Fang Cheng
Fang Cheng
Guolin Yuan
Qiang Li
Qiang Li
Zheng Cui
Zheng Cui
Weiming Li
Long-term outcomes of frontline imatinib therapy for chronic myeloid leukemia in China
Frontiers in Oncology
imatinib
chromic myeloid leukemia
pharmacotherapy
efficacy
drug safety
title Long-term outcomes of frontline imatinib therapy for chronic myeloid leukemia in China
title_full Long-term outcomes of frontline imatinib therapy for chronic myeloid leukemia in China
title_fullStr Long-term outcomes of frontline imatinib therapy for chronic myeloid leukemia in China
title_full_unstemmed Long-term outcomes of frontline imatinib therapy for chronic myeloid leukemia in China
title_short Long-term outcomes of frontline imatinib therapy for chronic myeloid leukemia in China
title_sort long term outcomes of frontline imatinib therapy for chronic myeloid leukemia in china
topic imatinib
chromic myeloid leukemia
pharmacotherapy
efficacy
drug safety
url https://www.frontiersin.org/articles/10.3389/fonc.2023.1172910/full
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