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- Title
Younger patients with chronic myeloid leukemia do well in spite of poor prognostic indicators: results from the randomized CML study IV.
- Authors
Kalmanti, Lida; Saussele, Susanne; Lauseker, Michael; Proetel, Ulrike; Müller, Martin; Hanfstein, Benjamin; Schreiber, Annette; Fabarius, Alice; Pfirrmann, Markus; Schnittger, Susanne; Dengler, Jolanta; Falge, Christiane; Kanz, Lothar; Neubauer, Andreas; Stegelmann, Frank; Pfreundschuh, Michael; Waller, Cornelius; Spiekermann, Karsten; Krause, Stefan; Heim, Dominik
- Abstract
Since the advent of tyrosine kinase inhibitors, the impact of age on outcome of chronic myeloid leukemia (CML) patients has changed. We therefore analyzed patients from the randomized CML study IV to investigate disease manifestations and outcome in different age groups. One thousand five hundred twenty-four patients with BCR-ABL-positive chronic phase CML were divided into four age groups: (1) 16-29 years, n = 120; (2) 30-44 years, n = 383; (3) 45-59 years, n = 495; and (4) ≥60 years, n = 526. Group 1 (adolescents and young adults (AYAs)) presented with more aggressive disease features (larger spleen size, more frequent symptoms of organomegaly, higher white blood count, higher percentage of peripheral blasts and lower hemoglobin levels) than the other age groups. In addition, a higher rate of patients with BCR-ABL transcript levels >10 % on the international scale (IS) at 3 months was observed. After a median observation time of 67.5 months, no inferior survival and no differences in cytogenetic and molecular remissions or progression rates were observed. We conclude that AYAs show more aggressive features and poor prognostic indicators possibly indicating differences in disease biology. This, however, does not affect outcome.
- Subjects
CHRONIC myeloid leukemia; RANDOMIZED controlled trials; PROTEIN-tyrosine kinase inhibitors; HEALTH outcome assessment; WATER quality biological assessment; PRELEUKEMIA
- Publication
Annals of Hematology, 2014, Vol 93, Issue 1, p71
- ISSN
0939-5555
- Publication type
Article
- DOI
10.1007/s00277-013-1937-4