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Outcome of patients with Philadelphia chromosome‐positive chronic myelogenous leukemia post‐imatinib mesylate failure
Author(s) -
Kantarjian Hagop,
O'Brien Susan,
Talpaz Moshe,
Borthakur Gautam,
Ravandi Farhad,
Faderl Stefan,
Verstovsek Srdan,
Rios Mary Beth,
Shan Jianqin,
Giles Francis,
Cortes Jorge
Publication year - 2007
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.22569
Subject(s) - medicine , nilotinib , imatinib , imatinib mesylate , chronic myelogenous leukemia , dasatinib , philadelphia chromosome , gastroenterology , oncology , leukemia , myeloid leukemia , chromosomal translocation , biochemistry , chemistry , gene
BACKGROUND. The prognosis of patients with chronic myelogenous leukemia (CML) after failure of imatinib mesylate therapy is not well documented. METHODS. The outcome of 420 patients with CML post‐imatinib failure (resistance‐recurrence in 374; toxicities in 46) were reviewed in relation to survival, overall, and by different therapies. RESULTS. The estimated 3‐year survival rates were 72% in 88 patients who progressed in chronic phase, 30% in 130 patients who progressed in accelerated phase, 7% in 156 patients who progressed in blastic phase, and 75% in 37 patients in chronic phase with imatinib intolerance. Survival in chronic phase was better when subsequent therapy was nilotinib or dasatinib vs allogeneic stem cell transplant vs others (estimated 2‐year survival rates 100% vs 72% vs 67%; P = .01), but not in accelerated‐blastic phase. CONCLUSIONS. Prognosis post‐imatinib failure in chronic phase is reasonable; it is poor if the CML phase post‐imatinib failure is accelerated or blastic. Cancer 2007. © 2007 American Cancer Society.