Efficacy and prognosis of chronic myeloid leukemia treated with imatinib mesylate in a Chinese population |
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Authors: | Yanmin Zhao Lizhen Liu Yingjia Wang Gongqiang Wu Xiaoyu Lai Weijie Cao Yi Luo Yamin Tan Jimin Shi Wanzhuo Xie Xiujin Ye Zhen Cai Maofang Lin He Huang |
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Institution: | (1) Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, 310003 Hangzhou, China |
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Abstract: | There is limited data from developing countries on the current status of imatinib treatment for chronic myeloid leukemia (CML),
thus we retrospectively analyzed 116 Chinese CML patients who received imatinib between 2003 and 2008. The response rates
for 102 patients in chronic phase were: complete hematologic, 94.1%; complete cytogenetic, 69.6%; and complete molecular response,
54.9%. For 14 patients in the accelerated phase, the respective response rates were 85.7, 35.7 and 28.6%. The 3-year progression-free
survival and 5-year overall survival were 73.3 and 74.8%. Although skin hypopigmentation occurs as the most common side effect
(77.6%), imatinib is still well tolerated. In addition to the known pretreatment characteristics of spleen size, leukocyte
and platelet counts, disease phase and Sokal scores, we found that delayed therapy, variant Philadelphia chromosome translocations
and IM-related grade 3/4 leucopenia were associated with an inferior cytogenetic response. Four factors emerged as predictors
of disease progression: molecular response, cytogenetic response, disease phase and disease duration prior to imatinib treatment,
but only the latter three remained significant after multivariate analysis. The results indicate that the suboptimal outcome
in Chinese patients is associated with delayed imatinib therapy, so the importance of the optimal treatment opportunity for
CML should be emphasized. |
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Keywords: | Chronic myeloid leukemia Imatinib Cytogenetic response Hypopigmentation Prognosis Chinese population |
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