Clinical results according to age in patients with chronic myeloid leukemia receiving imatinib frontline: The younger, the later, the worse?

ObjectivesTo evaluate differences in clinical results according to age among patients with chronic myeloid leukemia (CML). Methods207 consecutive CML patients treated with imatinib frontline were revised, dividing them in young adults (>20<45years) (YA), middle-aged adults (45<65years) (MA) and elderly (65years) (EL). ResultsCumulative incidence of complete cytogenetic response (CCyR) and major molecular response (MMolR) were significantly higher in MA compared with YA and EL (P<.001 for CCyR and P=.001 for MMolR). Number of total events was lower in MA (8 [11.1%] vs 21 [34.4%] in YA and 28 [37.8%] in EL, P=.001): no difference was observed for blastic evolution (P=.478). Number of deaths was higher in the EL (12 [16.2%] vs 2 [3.2%] in YA and 0 in MA, P<.001): however, 11/12 deaths in EL were not related to CML. The PFS curve in MA was significantly longer than in YA and in EL (P=.02). The OS curve in EL was significantly shorter than in YA and in MA (P<.001). ConclusionsAge at diagnosis influences significantly the course of CML patients treated with imatinib: a possible explanation of the counterintuitive worse course in YA is the delayed diagnosis compared to elderly.