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Significance of myelofibrosis in early chronic‐phase, chronic myelogenous leukemia on imatinib mesylate therapy
Author(s) -
Kantarjian Hagop M.,
BuesoRamos Carlos E.,
Talpaz Moshe,
O'Brien Susan,
Giles Francis,
Faderl Stefan,
Wierda William,
Rios Mary Beth,
Shan Jianqin,
Cortes Jorge
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21235
Subject(s) - medicine , imatinib mesylate , myelofibrosis , chronic myelogenous leukemia , gastroenterology , imatinib , philadelphia chromosome , clinical significance , bone marrow , cancer , oncology , pathology , leukemia , myeloid leukemia , chromosomal translocation , biochemistry , chemistry , gene
BACKGROUND Myelofibrosis is associated historically with a poor prognosis in patients with chronic myelogenous leukemia (CML). Its significance in the recent era of effective therapy with imatinib mesylate is unknown. METHODS The current study evaluated the significance of the degree of pretreatment myelofibrosis on response and survival with imatinib therapy in patients with newly diagnosed CML. The study group comprised 198 patients with newly diagnosed Philadelphia chromosome‐positive, chronic‐phase CML treated with imatinib mesylate therapy. They were analyzed for the prognostic significance of bone marrow reticulin fibrosis. RESULTS Severe reticulin (Grade 3–4) fibrosis was observed in 75 patients (38%): Grade 3 in 46 (23%) patients and Grade 4 in 29 (15%) patients. There was a trend towards a lower incidence of a complete cytogenetic response in patients with Grade 4 reticulin fibrosis (76% vs. 89%; P = 0.07), and a significantly worse survival (estimated 3‐year survival rate of 87% vs. 97%; P = 0.04). CONCLUSIONS Although the prognostic significance of severe reticulin fibrosis in patients with newly diagnosed CML receiving imatinib therapy was better, 15% of patients with Grade 4 reticulin fibrosis still had a worse outcome. Cancer 2005. © 2005 American Cancer Society.