Imatinib for Newly Diagnosed Patients With Chronic Myeloid Leukemia: Incidence of Sustained Responses in an Intention-to-Treat Analysis

Abstract

Imatinib is highly effective in most patients with CML-CP; patients who respond are likely to live substantially longer than those treated with earlier therapies. Achieving CCyR correlated with PFS and overall survival, but achieving MMR had no further predictive value. However, approximately one third of patients still need better therapy.

Early molecular and cytogenetic response is predictive for long-term progression-free and overall survival in chronic myeloid leukemia (CML)

“…Under imatinib treatment, the lack of CHR at 3 months was associated with a low rate of subsequent CCyR and inferior 5-year PFS and OS. 29 The failure to reach CHR by 3 months is considered as imatinib failure by the 2009 ELN management recommendations. 4 Our first report on the predictive value of molecular response at 3 months 30 was confirmed by others.…”

Effective Molecular Monitoring and the Proper Management of Pleural Effusion During the First-Line Dasatinib Administration in CML

“…Achievement of CCyR and/ or MMR within 12-month after the ini- tiation of treatment was predictive of long-term treatment success regarding prolonged CCyR, very low risk of long-term progression, higher rate of OS, PFS, EFS and low risk for loss of CCyR. [14][15][16][17][18] Thus, achieving both a CCyR and MMR more quickly and at a higher rates should be an important treatment goal.…”

Hematopoietic Stem Cells in Chronic Myeloid Leukemia

“…Two types of resistance mechanisms to TKIs have been described: 1) Primary resistance, which occurs in less than 10% of cases and is defined as the failure of therapeutic effect during the chronic phase of CML without changing clones; and 2) secondary resistance, defined as the loss of the response initially obtained, and commonly occurs in accelerated phase (40-50%) and blast (80%) [90] It is estimated that the probability of an individual to stay in CCR for 5 years after diagnosis, after treatment with Imatinib is approximately 63%; however, this percentage may represent a sub-estimation since in a significant proportion of cases there is discontinuation of treatment and this, of course, may underestimate the efficacy of the drug [91].…”