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Blood (ASH Annual Meeting Abstracts) 2005 106: Abstract 1103
© 2005 American Society of Hematology
Poster Sessions
Correlation of Different
Responses to Imatinib on
Survival of Patients (pts) with
Chronic Myelogenous Leukemia
(CML) in Accelerated (AP) and
Blast Phase (BP).
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Articles by Aoki, E.
Etsuko Aoki, MD, PhD1,*, Hagop Kantarjian,
Articles by Cortes, J.
MD1, Susan O’Brien, MD1, Mary Beth Rios,
R.N.1,*, Farhad Ravandi, MD1, Srdan Verstovsek,
MD1, Guillermo Garcia-Manero, MD1, Jianqin Shan, PhD1,* and Jorge Cortes,
MD1
1
Leukemia, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA .
Abstract
Imatinib has remarkable activity in CML in all phases, with high rates of hematologic
and cytogenetic response. However, in AP and BP responses are frequently less than
complete hematologic remission (CHR), including partial hematologic remission (PHR)
and return to chronic phase (second CP). The objective of this study was to investigate
whether different responses to imatinib conferred a survival advantage in pts with CML
in AP and BP. We evaluated 214 pts in AP and 76 pts in BP (11 lymphoid, 63 myeloid,
2 unclassified) treated with imatinib. Median age for AP pts was 49 yrs (range: 22–82
yrs) and for BP, 54 yrs (19–75 yrs). With a median follow-up of 49 months (1.9–67.5
months), 82 (38%) AP and 66 (87%) BP pts have died. A CHR and major cytogenetic
(CG) response (MCR) have been achieved in 87% and 53% of AP pts, and 37% and
14% of BP pts, respectively. For AP pts the median overall survival (OS) and
progression free survival (PFS) were 65 and 49 months, respectively. In BP pts, median
OS and PFS were 7 and 3 months. The OS by best response to imatinib was as follows:
Page:
Response
No.
(%)
Median OS
(months)
p value
Median PFS
(months)
p value
Not reached
<0.0001
Not reached
<0.0001
Accelerated phase
CG CR
96
(45)
CG PR
13 (6) 43
28
CG minor
13 (6) 48
31
CHR
57
(27)
22
PHR
16 (7) 14
6
Resistant
11 (5) 5
3
34
Blast Phase
CG CR
6 (8)
Not reached
CG PR +
minor
8 (11) 12
<0.0001
Not reached
5
12
CHR + PHR (16)
13
11
Second CP
6 (8)
9
4
Marrow
CR/PR
9 (12) 5
4
25
(33)
2
Resistant
4
<0.0001
CG CR=complete CG response (Ph=0%), CG PR=partial CG response (Ph<35%),
CG minor=minor CG response (Ph=35–95%), Marrow CR/PR=marrow
complete/partial response
We conclude that although cytogenetic responses confer the most survival advantage in
AP and BP after imatinib therapy, hematologic responses are associated with a survival
benefit.
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