Impact of imatinib interruption and duration of prior hydroxyurea on the treatment outcome in patients with chronic myeloid leukemia: Single institution experience

Edesa, Wael; Abdel-Malek, Raafat

doi:10.1016/j.jnci.2015.03.004

Cited by 8 publications

(9 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The low response rate in our cohort may be due to the delay between diagnosis and treatment. Incomplete adherence to the treatment is also likely to have an impact on the low response rates we observed, as several studies demonstrate that the poor adherence to the treatment is associated with a lower response in CML [22][23][24].…”

Section: Discussionmentioning

confidence: 95%

Pattern of chronic myeloid leukemia in the imatinib era in a Sub-Saharan African setting

et al. 2016

View full text Add to dashboard Cite

Chronic myeloid leukemia (CML) is an orphan disease in Africa because of the inaccessibility to specific treatment and the high cost of diagnosis and monitoring patients. The aim of this study was to report CML treatment response in a developing country in the tyrosine kinase inhibitor era. We conducted a longitudinal study of our cohort of CML patients. Socio-demographic, diagnosis, therapeutic, and treatment response parameters were studied. Sokal score, disease phase at diagnosis, delay from diagnosis to treatment, and treatment response were analyzed for their impact on survival. Fifty-five patients with a diagnosis of CML and who received treatment with imatinib for a minimum of 3 months were included in this study. Median follow-up was 170 patient-years. The sex ratio (M/F) was 1.62 and median age at diagnosis was 42 years. At diagnosis, 85.5 % of the patients were in chronic phase (CP), 12.7 % in accelerated phase (AP), and 1.8 % in blast crisis (BC). Sokal risk score distribution was as follows: low risk 29.8 %, intermediate risk 38.3 %, and high risk 31.9 %. Median time from first symptoms to first medical visit was 6.2 months and median time from first medical visit to cytogenetic and or molecular confirmation was 12.4 months. Mean delay time from first medical visit to imatinib initiation was 12.5 months (95 % CI 6.3-18.7). The complete hematologic response (CHR) at 3 months, the major cytogenetic response (MCR) at 12 months, and the major molecular response (MMR) at 24 months were respectively 82.4, 75, and 25 %. The 2-year overall survival rate was 81 %. Advanced phase at the diagnosis, discontinuation of imatinib therapy over 15 % of the time, lack of CHR at 3 months, lack of MCR at 12 months, and progression of the disease during imatinib therapy were associated with a risk of death (p ≤ 0.05). Our data confirm the improved prognosis of CML treated with imatinib in the setting of a developing country. However, response rates are lower than in developed countries, and additional efforts should be made to facilitate early diagnosis and improve access to TKI, treatment compliance, and regular molecular monitoring of patients.

show abstract

Section: Discussionmentioning

confidence: 95%

Pattern of chronic myeloid leukemia in the imatinib era in a Sub-Saharan African setting

et al. 2016

View full text Add to dashboard Cite

show abstract

“…These results were conflicting to those of Edesa and his colleague. [40] The appropriate explanation of these conflicting results is much longer duration of disease in patients of this study that ranged from 3-120 months.…”

Section: Discussionmentioning

confidence: 71%

Treatment with Tyrosine Kinase Inhibitors in Chronic Myeloproliferative Neoplasms: Pros and Cons

Khaled¹

2016

AJIM

View full text Add to dashboard Cite

Myeloproliferative neoplasms (MPNs) are a group of hematological disorders characterized by proliferation of one or more than one myeloid lineage. Genetically they express single or multiple mutations of the Janus tyrosine kinase receptors. Advances in understanding molecular and cytogenetic pathophysiology of MPNs led to further identification of different mutations rather than the classical break point cluster region Abelson (BCR-ABL). Although the onset of disease in all MPNs is insidious and may be asymptomatic, also MPNs run a slowly progressive course however they carry the potential of blastic transformation. Furthermore, peripheral blood leucocytosis, thrombocytosis or erythroctosis can lead to a wide array of fatal complications. Originally treatment of MPNs based on cytoreduction and supportive measures. Tyrosine kinase inhibitors (TKIs) are a group of anti-neoplastic drugs that specifically targeting malignant cells. Many studies proved the efficacy and safety of TKIs in management of patients with MPNs. This study was conducted to evaluate TKIs, pros and cons.

show abstract

“…Figure 3: Kaplan-Meier analysis of the overall survival (OS) probability. Edesa and Abdel-malek [23] showed no statistically significant difference was observed in PFS according to EUTOS score. Marin et al [19] and Jabbour et al [29] evaluated the clinical significance of the EUTOS score and reported both negative findings.…”

Section: Discussionmentioning

confidence: 80%

“…In Egypt, Heiba and Elshazly [22] showed that 17 (30%), 24 (43%) and 15 (27%) patients were in the Sokal low, intermediate and high risk groups respectively in a study including 56 CML-CP patients. Also in Egypt, Edesa and Abdel-malek [23] showed that the majority of the cases had low risk (75%) according to EUTOS scoring system in a study including 60 CML-CP patients. The discrepancy in the reported figures between several studies, including our study, could be due to several factors.…”

Section: Discussionmentioning

confidence: 94%

“…To our knowledge, this is the first study to use data from Egyptian patients for comparing different score systems for CML prognosis and the first study to assess the ELTS score worldwide after the original paper by Pfirrmann et al [13] The percentages of different risk groups among different scoring systems had many different figures in different studies [11,13,[19][20][21][22][23][24][25][26][27][28][29][30][31][32]. In Egypt, Heiba and Elshazly [22] showed that 17 (30%), 24 (43%) and 15 (27%) patients were in the Sokal low, intermediate and high risk groups respectively in a study including 56 CML-CP patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Utility and Applicability of Chronic Myeloid Leukemia Scoring Systems for Predicting the Prognosis of Egyptian Patients on Imatinib: Retrospective Study

Elbedewy¹,

Elashtokhy²

2016

J Leuk

View full text Add to dashboard Cite

Background: Chronic myeloid leukemia (CML) is myeloproliferative clonal neoplasm. Imatinib has greatly improved CML prognosis. Many prognostic scoring systems have been developed for CML risk stratification. In clinical practice, 3 systems are widely used: Sokal, Hasford and European Treatment Outcome Study (EUTOS). Recently, EUTOS long-term survival (ELTS) score is the first long-term scoring system that considered specifically CML-related death. Therefore, the aim of the present study was to validate the effectiveness of Sokal, Hasford, EUTOS and ELTS scoring systems in predicting the outcome in Egyptian CML-chronic phase (CML-CP) patients treated with imatinib. Patients and methods: Retrospective study performed on 167 patients with CML-CP who were treated with imatinib. Using the Sokal, Hasford, EUTOS and ELTS scores, we divided the patients into each risk groups. Results: Significant differences in event free survival (EFS), time without progression (TWP) and overall survival (OS) prediction between the Sokal, Hasford and ELTS risk groups, but no significant difference among the EUTOS score risk groups. Conclusion: Our study indicates that Sokal, Hasford and ELTS scoring systems but not the EUTOS score are effective in predicting early treatment response, EFS, TWP and OS for Egyptian CML patients treated with imatinib.

show abstract

Impact of imatinib interruption and duration of prior hydroxyurea on the treatment outcome in patients with chronic myeloid leukemia: Single institution experience

Cited by 8 publications

References 42 publications

Pattern of chronic myeloid leukemia in the imatinib era in a Sub-Saharan African setting

Pattern of chronic myeloid leukemia in the imatinib era in a Sub-Saharan African setting

Treatment with Tyrosine Kinase Inhibitors in Chronic Myeloproliferative Neoplasms: Pros and Cons

The Utility and Applicability of Chronic Myeloid Leukemia Scoring Systems for Predicting the Prognosis of Egyptian Patients on Imatinib: Retrospective Study

Contact Info

Product

Resources

About