Younger patients with chronic myeloid leukemia do well in spite of poor prognostic indicators: results from the randomized CML study IV

被引：55

作者：

Kalmanti, Lida ^{[1
]}

Saussele, Susanne ^{[1
]}

Lauseker, Michael ^{[2
]}

Proetel, Ulrike ^{[1
]}

Mueller, Martin C. ^{[1
]}

Hanfstein, Benjamin ^{[1
]}

Schreiber, Annette ^{[1
]}

Fabarius, Alice ^{[1
]}

Pfirrmann, Markus ^{[2
]}

Schnittger, Susanne ^{[3
]}

Dengler, Jolanta ^{[4
]}

Falge, Christiane ^{[5
]}

Kanz, Lothar ^{[6
]}

Neubauer, Andreas ^{[7
]}

Stegelmann, Frank ^{[8
]}

Pfreundschuh, Michael ^{[9
]}

Waller, Cornelius F. ^{[10
]}

Spiekermann, Karsten ^{[11
]}

Krause, Stefan W. ^{[12
]}

Heim, Dominik ^{[13
]}

Nerl, Christoph ^{[14
]}

Hossfeld, Dieter K. ^{[15
]}

Kolb, Hans-Jochem ^{[16
]}

Hochhaus, Andreas ^{[17
]}

Hasford, Joerg ^{[2
]}

Hehlmann, Ruediger ^{[1
]}

机构：

[1] Univ Mannheim, Med Klin, D-68169 Mannheim, Germany

[2] Univ Munich, Ins Med Informat Verarbeitung, Biometrie Epidemiol IBE, Munich, Germany

[3] MLL Munchner Leukamielabor GmbH, Munich, Germany

[4] Univ Klinikum Heidelberg, Abteilung Innere Med 5, Med Klin, Heidelberg, Germany

[5] Klinikum Nurnberg Nord, Med Klin 5, Nurnberg, Germany

[6] Univ Klinikum Tubingen, Med Klin, Abteilung 2, Tubingen, Germany

[7] Univ Klinikum Marburg, Innere Med Klin, Schwerpunkt Hamatol Onkol & Immunol, Marburg, Germany

[8] Univ Ulm Klinikum, Innere Med Klin 3, Ulm, Germany

[9] Univ Saarlandes Kliniken, Innere Med Klin 1, Homburg, Germany

[10] Univ Freiburg Klinikum, Innere Med Klin 1, Freiburg, Germany

[11] Klinikum Ludwig Maximilians Univ, Med Klin & Poliklin 3, Munich, Germany

[12] Univ Klinikum Erlangen, Med Klin 5, Erlangen, Germany

[13] Univ Spital, Klin Hamatol, Basel, Switzerland

[14] Klin Schwabing, Klin Hamatol Onkol Immunol Palliativ Med Infektio, Munich, Germany

[15] Univ Klinikum Eppendorf, Med Klin 2, Hamburg, Germany

[16] Tech Univ Munich, Klinikum Rechts Isar, D-80290 Munich, Germany

[17] Univ Klinikum Jena, Abteilung Hamatol Onkol, Jena, Germany

来源：

ANNALS OF HEMATOLOGY | 2014年 / 93卷 / 01期

关键词：

Chronicmyeloid leukemia; Accelerated phase; Blast crisis; Young adults and adolescents; TYROSINE KINASE INHIBITORS; CLINICAL-TRIALS; CANCER; ADOLESCENTS; AGE; IMATINIB; ADULTS; DIAGNOSIS; THERAPY; IMPACT;

D O I：

10.1007/s00277-013-1937-4

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Since the advent of tyrosine kinase inhibitors, the impact of age on outcome of chronic myeloid leukemia (CML) patients has changed. We therefore analyzed patients from the randomized CML study IV to investigate disease manifestations and outcome in different age groups. One thousand five hundred twenty-four patients with BCR-ABL-positive chronic phase CML were divided into four age groups: (1) 16-29 years, n = 120; (2) 30-44 years, n = 383; (3) 45-59 years, n = 495; and (4) a parts per thousand yen60 years, n = 526. Group 1 (adolescents and young adults (AYAs)) presented with more aggressive disease features (larger spleen size, more frequent symptoms of organomegaly, higher white blood count, higher percentage of peripheral blasts and lower hemoglobin levels) than the other age groups. In addition, a higher rate of patients with BCR-ABL transcript levels > 10 % on the international scale (IS) at 3 months was observed. After a median observation time of 67.5 months, no inferior survival and no differences in cytogenetic and molecular remissions or progression rates were observed. We conclude that AYAs show more aggressive features and poor prognostic indicators possibly indicating differences in disease biology. This, however, does not affect outcome.

引用

页码：71 / 80

页数：10

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