Please use this identifier to cite or link to this item: http://hdl.handle.net/1959.13/42906

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Title
Impact of early dose intensity on cytogenetic and molecular responses in chronic- phase CML patients receiving 600 mg/day of imatinib as initial therapy
Author/Creator
Hughes, Timothy P.;  Branford, Susan;  Cooney, Julian;  Leahy, Michael F.;  Rowlings, Philip;  Catalano, John;  Hertzberg, Mark;  Filshie, Robin;  Mills, Anthony K.;  Fay, Keith;  Durrant, Simon;  Januszewicz, Henry;  White, Deborah L.;  Joske, David;  Underhill, Craig;  Dunkley, Scott;  Lynch, Kevin;  Grigg, Andrew;  Reynolds, John;  Koelmeyer, Rachel;  Seymour, John F.;  Taylor, Kerry;  Arthur, Chris;  Schwarer, Anthony K.;  Morton, James
Institution
The University of Newcastle. Faculty of Health, School of Medicine and Public Health
Description
We conducted a trial in 103 patients with newly diagnosed chronic phase chronic myeloid leukemia (CP-CML) using imatinib 600 mg/day, with dose escalation to 800 mg/day for suboptimal response. The estimated cumulative incidences of complete cytogenetic response (CCR) by 12 and 24 months were 88% and 90%, and major molecular responses (MMRs) were 47% and 73%. In patients who maintained a daily average of 600 mg of imatinib for the first 6 months (n = 60), MMR rates by 12 and 24 months were 55% and 77% compared with 32% and 53% in patients averaging less than 600 mg (P = .037 and .016, respectively). Dose escalation was indicated for 17 patients before 12 months for failure to achieve, or maintain, major cytogenetic response at 6 months or CCR at 9 months but was only possible in 8 patients (47%). Dose escalation was indicated for 73 patients after 12 months because their BCR-ABL level remained more than 0.01% (international scale) and was possible in 45 of 73 (62%). Superior responses achieved in patients able to tolerate imatinib at 600 mg suggests that early dose intensity may be critical to optimize response in CP-CML. The trial was registered at www.ANZCTR.org.au as #ACTRN12607000614493.
Relation
Blood Vol. 112, Issue 10, p. 3965-3973
Publisher Link
http://dx.doi.org/10.1182/blood-2008-06-161737
Date
2008
Publisher
American Society of Hematology
Keyword(s)
chronic phase chronic myeloid leukemia (CP-CML);  imatinib mesylate;  cytogenetic response;  dose intensity
Resource Type
journal article
Identifier
http://hdl.handle.net/1959.13/42906
Identifier
ISSN:0006-4971
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Reviewed
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Subject
"Blood"
 
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