Therapy of chronic myeloid leukemia with imatinib mesylate in Brazil: a study of 98 cases

Funke, Vaneuza Araújo Moreira; Medeiro, Carlos R.; Lima, Denise H.; Setubal, D.C.; Bitencourt, Marco A.; Bonfim, Carmem; Ruiz, J.; Neto, José Zanis; Pasqüini, Ricardo

doi:10.1590/s1516-84842005000300005

Cited by 16 publications

(14 citation statements)

References 14 publications

(21 reference statements)

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“…Unlike reports from high-resource countries, 33,39 the median age of our patients was only 35 years, which was similar to the median age of patients in the Brazilian study. 40 Shorter life expectancy in developing countries 41 or under diagnosis in the geriatric population may account for the younger age of our patients.…”

Section: Discussionmentioning

confidence: 96%

“…We could identify only 1 study from Brazil that reported results on imatinib in patients with CML. 40 Our patient population is not a selective population, because >95% of patients with CML across our country participate in 4 expanded-access programs. Most of our patients on IFN were unable to tolerate the recommended doses because of severe side effects.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of chronic myeloid leukemia in the imatinib era

Aziz

Iqbal

Akram

et al. 2007

Cancer

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BACKGROUNDThere is paucity of data from developing countries on the efficacy and safety of imatinib mesylate in chronic myeloid leukemia (CML). The primary objective of this study was to document complete and partial cytogenetic responses to imatinib in all phases of CML. Secondary objectives included evaluations of complete hematologic response, safety, time to progression, and survival.METHODSTwo hundred seventy‐five patients in all phases of CML who received treatment with imatinib from January 2001 to December 2005 were included in the study. All patients had on bone marrow or BCR‐ABL positive in peripheral blood by polymerase chain reaction.RESULTSAfter a median follow‐up of 18 months, major cytogenetic responses (Ph <35%) in chronic phase (CP), accelerated phase (AP), and blastic phase (BP) were documented in 61%, 57%, and 28% of patients, respectively. A complete cytogenetic response was observed in 39.4%, 35.7%, and 14.3% of patients in CP, AP, and BP, respectively; and a complete hematologic response was observed in 90%, 86%, and 30%, respectively. The median time to progression at 18 months was 91% in CP and 68% in AP. The overall survivals in CP, AP, and BP at 18 months was 92%, 74%, and 38%, respectively.CONCLUSIONSImpressive hematologic, cytogenetic, and molecular responses to imatinib were observed, similar to the responses reported in patients from Western countries. Patients had good compliance, toxicity was limited, and overall quality of life was improved markedly. The results indicated that the biology of CML is not different in patients from developing countries. Cancer 2007 © 2007 American Cancer Society.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Treatment of chronic myeloid leukemia in the imatinib era

Aziz

Iqbal

Akram

et al. 2007

Cancer

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“…Since then, several publications have shown the results of treatment in similar groups (Kantarjian et al, 2004a,b;Funke et al, 2005;Lahaye et al, 2005). In this study, we analyzed patients at our institution who were treated with second-line IM and called them "pre-treated", as some were in late chronic phase (over a year since diagnosis) and others not.…”

Section: Discussionmentioning

confidence: 99%

“…Response was defined as major if the patient had a complete or partial response. Molecular response was described as previously defined (Kantarjian et al, 2002a;Hughes et al, 2003;Funke et al, 2005). Occurrence of events in patient outcome was defined as: death (any cause), progression to advanced stages of disease (accelerated phase and/or blast crisis) (Cortes and Kantarjian, 2003;Giles et al, 2004) and loss of responses (hematologic, cytogenetic or molecular).…”

Section: Study Design and Statistical Analysismentioning

confidence: 99%

Response to treatment with imatinib mesylate in previously treated chronic-phase chronic myeloid leukemia patients in a hospital in Brazil

Silveira¹,

Daldegan²,

Ferrari³

2011

Genet. Mol. Res.

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ABSTRACT. We analyzed the results of treatment with imatinib mesylate in 70 patients with chronic-phase chronic myeloid leukemia who had previously been treated (with second-line or higher imatinib), many of them in a late chronic phase. The median followup period was 60.5 months (range 3-100 months). Our objective was to assess the efficacy and safety of treatment. The mean dose was 400 mg per day. The hematologic response rate was 92.1% at six months, while the cumulative rates of major and complete cytogenetic responses were 73.6 and 66.3%, respectively. Molecular response rate improved slowly and steadily over time, reaching 65.8% at 60 months, remaining stable for up to 96 months. The five-year progression-free survival and overall survival were 84 and 89%, respectively. Cytogenetic response by 12 months significantly correlated with overall survival (P = 0.0007) and progression-free survival (P = 0.0280). Sokal risk score did not differ significantly between subgroups. The medication was well tolerated, with only Imatinib mesylate in chronic myeloid leukemia 16% of patients showing hematologic toxicity grades 3 and 4. At the end of the assessment, 57% of the patients were still on imatinib mesylate; most of those who discontinued treatment (17/30) did so because of unsatisfactory response. Treatment with imatinib mesylate in previously treated chronic-phase chronic myeloid leukemia induced durable responses in a high proportion of patients and was related to satisfactory long-term and event-free survival.

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“…Os eventos adversos nos pacientes que utilizaram esta droga são mínimos e se assemelham aos relatados na literatura, exceto pela menor incidência de sintomas gastrointestinais e cãimbras. 19 O imatinibe tem sido confirmado como terapia de primeira linha para a LMC por apresentar respostas duradouras na maior parte dos pacientes, principalmente nos que se encontram em fase crônica da doença; entretanto, alguns pacientes ainda em fase crônica e uma maior proporção em fases mais avançadas da LMC apresentam resistência ou intolerância ao imatinibe. 16,17,20,21 A resistência ao imatinibe pode ser desenvolvida por vários mecanismos moleculares, como a superexpressão de BCR-ABL, mutações no sítio de ligação BCR-ABL, entre outras; entretanto, os pontos de mutação no BCR-ABL constituem a ocorrência mais comum para a resistência a esta droga.…”

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Inibidores de tirosino quinase na leucemia mieloide crônica

Lopes¹,

Abreu²

2009

Rev. Bras. Hematol. Hemoter.

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A leucemia mieloide crônica (LMC) é uma neoplasia da medula óssea originada da translocação entre os cromossomos 9 e 22 t (9:22)(q34;11) Palavras-chave: Tirosino quinase; leucemia mieloide crônica; tratamento.A leucemia mieloide crônica (LMC) é uma neoplasia da medula óssea que transforma a célula progenitora hematopoética normal em maligna. 1 É ocasionada por uma translocação entre os cromossomos 9 e 22 t(9:22)(q34;11), 1,2,3 determinando assim a presença do cromossomo Philadelfia (Ph + ), que é resultante da junção da região do gene BCR do cromossomo 22 com o gene ABL do cromossomo 9, gerando o gene híbrido BCR-ABL no cromossomo 22 q-. 1,4O gene híbrido BCR-ABL produz uma proteína quimé-rica com atividade tirosino quinase elevada que é responsá-vel pela patogênese da LMC. O resultado desta atividade elevada induz a medula óssea a proliferar um clone de células mieloides malignas constantemente, resultando um número excessivo destas células. 2Em condições normais, o gene BCR expresso no cromossomo 22 codifica uma proteína com função relacionada à regulação do ciclo celular, enquanto o gene ABL expresso no cromossomo 9 codifica uma proteína tirosino quinase. Por ser uma enzima que participa do metabolismo celular, a tirosino quinase está relacionada a várias patologi-

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Therapy of chronic myeloid leukemia with imatinib mesylate in Brazil: a study of 98 cases

Abstract: Correspondence to : Vaneuza A. M. Funke Rua da Paz, 412, apt 151 -Centro 80060-160 -Curitiba-PR -Brazil Tel.: 055 41 3601000 -Fax: 055 41 3601015 E-mail: vaneuza@brturbo.com group. Rev. bras. hematol. hemoter. 2005;27(3):159-165.

Cited by 16 publications

References 14 publications

Treatment of chronic myeloid leukemia in the imatinib era

Treatment of chronic myeloid leukemia in the imatinib era

Response to treatment with imatinib mesylate in previously treated chronic-phase chronic myeloid leukemia patients in a hospital in Brazil

Inibidores de tirosino quinase na leucemia mieloide crônica

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