Conflict of interest: VGG: Novartis: Membership on an entity's Board of Directors or advisory committees; BMS: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees. LFC: Novartis: Consultancy, Speakers Bureau; BMS: Consultancy, Speakers Bureau; Pfizer: Consultancy, Speakers Bureau. JML: Celgene: Honoraria. JLS: Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Pfizer: Consultancy, Speakers Bureau. JMH, MPE, MMR, IM,RSG, RP, MRS, MMV, JS, MP, GB, MDN, PG, MJJ, CB, JRA, MP, MR, MFV, CC, APC, RFO, PC, DTP, MFM, and PLG declare no conflict of interest.
Do chronic myeloid leukemia patients with late “warning” responses benefit from “watch and wait” or switching therapy to a second generation tyrosine kinase inhibitor?
Article first published online: 27 AUG 2014
© 2014 Wiley Periodicals, Inc.
American Journal of Hematology
Volume 89, Issue 11, pages E206–E211, November 2014
How to Cite
García-Gutiérrez, V., Puerta, J. M., Maestro, B., Casado Montero, L. F., Muriel, A., Molina Hurtado, J. R., Perez-Encinas, M., Moreno Romero, M. V., Suñol, P. B., Sola Garcia, R., De Paz, R., Ramirez Sanchez, M. J., Osorio, S., Mata Vazquez, M. I., Martinez López, J., Sastre, J. L., Portero, M. d. l. A., Bautista, G., Duran Nieto, M. S., Giraldo, P., Jimenez Jambrina, M., Burgaleta, C., Ruiz Aredondo, J., Peñarrubia, M. J., Requena, M. J., Fernández Valle, M. d. C., Calle, C., Paz Coll, A., Hernández-Rivas, J. Á., Franco Osorio, R., Cano, P., Tallón Pérez, D., Fernández de la Mata, M., Garrido, P. L. and Steegmann, J. L. (2014), Do chronic myeloid leukemia patients with late “warning” responses benefit from “watch and wait” or switching therapy to a second generation tyrosine kinase inhibitor?. Am. J. Hematol., 89: E206–E211. doi: 10.1002/ajh.23816
- Issue published online: 16 OCT 2014
- Article first published online: 27 AUG 2014
- Accepted manuscript online: 24 JUL 2014 11:27AM EST
- Manuscript Accepted: 22 JUL 2014
- Manuscript Received: 16 JUL 2014
- Spanish “Instituto de Salud Carlos III . Grant Number: PI07/91015
In the latest recommendations for the management of chronic-phase chronic myeloid leukemia suboptimal responses have been reclassified as “warning responses.” In contrast to previous recommendations current guidance advises close monitoring without changing therapy. We have identified 198 patients treated with first-line imatinib, with a warning response after 12 months of treatment (patients with a complete cytogenetic response but no major molecular response [MMR]). One hundred and forty-six patients remained on imatinib, while 52 patients changed treatment to a second generation tyrosine kinase inhibitor (2GTKI). Changing therapy did not correlate with an increase in overall survival or progression-free survival. Nevertheless, a significant improvement was observed in the probability of a MMR: 24% vs. 42% by 12 months and 43% vs. 64% by 24 months (P = 0.002); as well as the probability of achieving a deep molecular responses (MR4.5): 1% vs. 17% and 7% vs. 23% by 12 and 24 months, respectively (P = <0.001) .The treatment change to 2GTKI remained safe; however, we have observed a 19% of treatment discontinuation due to side effects. We have observed an improvement of molecular responses after changing treatment to 2GTKI in patients with late suboptimal response treated with imatinib first line. However, these benefits were not correlated with an improvement of progression free survival or overall survival. Am. J. Hematol. 89:E206–E211, 2014. © 2014 Wiley Periodicals, Inc.