DOI: 10.1002/cncr.11863. The significance of myelosuppression during therapy with imatinib mesylate in patients with chronic myelogenous leukemia in chronic phase

The significance of myelosuppression during therapy with imatinib mesylate in patients with chronic myelogenous leukemia in chronic phase

10.1002/cncr.11863

Crossref journal-article

Wiley

Cancer (311)

Abstract

AbstractBACKGROUNDImatinib mesylate induces high rates of hematologic and cytogenetic response in patients with chronic myelogenous leukemia (CML). During therapy with imatinib, up to 45% of patients with CML reportedly experience myelosuppression ≥ Grade 3, requiring interruption of therapy and/or dose reductions. The significance of myelosuppression for response to imatinib is unknown.METHODSThe authors analyzed 143 patients with late chronic‐phase CML who were treated with imatinib after failing interferon. Univariate and multivariate analyses were performed to determine patient characteristics that were correlated with myelosuppression response and the association between myelosuppression and cytogenetic response.RESULTSNeutropenia ≥ Grade 3 (according to National Cancer Institute Common Toxicity Criteria) occurred in 64 patients (45%), and thrombocytopenia ≥ Grade 3 occurred in 31 patients (22%). Any myelosuppression ≥ Grade 3 was associated with a lower rate of major (P = 0.04) or complete (P = 0.01) cytogenetic responses. This was more pronounced with myelosuppression that lasted > 2 weeks. The major cytogenetic response rate was 58% with Grade ≥ 3 myelosuppression compared with a rate of 75% without Grade ≥3 myelosuppression (P = 0.03); the complete cytogenetic response rates were 36% and 63%, respectively (P = 0.001). In a multivariate analysis, pretreatment platelet count, imatinib dose reductions, and duration of myelosuppression were associated significantly with response.CONCLUSIONSMyelosuppression is an independent adverse factor for achieving cytogenetic response with imatinib in patients with CML. Intervention with hematopoietic growth factors in patients with CML who are treated with imatinib should be investigated. Cancer 2004;100:116–21. © 2003 American Cancer Society.

Bibliography

Sneed, T. B., Kantarjian, H. M., Talpaz, M., OâBrien, S., Rios, M. B., Bekele, B. N., Zhou, X., Resta, D., Wierda, W., Faderl, S., Giles, F., & Cortes, J. E. (2003). The significance of myelosuppression during therapy with imatinib mesylate in patients with chronic myelogenous leukemia in chronic phase. Cancer, 100(1), 116â121. Portico.

Authors 12

Thomas B. Sneed (first)
Hagop M. Kantarjian (additional)
Moshe Talpaz (additional)
Susan O'Brien (additional)
Mary Beth Rios (additional)
B. Nebiyou Bekele (additional)
Xian Zhou (additional)
Debra Resta (additional)
William Wierda (additional)
Stefan Faderl (additional)
Francis Giles (additional)
Jorge E. Cortes (additional)

References 22 Referenced 100

{'key': 'e_1_2_5_2_2', 'first-page': '1661', 'article-title': 'Selective inhibition of cell proliferation and BCR‐ABL phosphorylation in acute lymphoblastic leukemia cells expressing Mr 190,000 BCR‐ABL protein by a tyrosine kinase inhibitor (CGP‐57148)', 'volume': '4', 'author': 'Beran M', 'year': '1998', 'journal-title': 'Clin Cancer Res.'} / Clin Cancer Res. / Selective inhibition of cell proliferation and BCR‐ABL phosphorylation in acute lymphoblastic leukemia cells expressing Mr 190,000 BCR‐ABL protein by a tyrosine kinase inhibitor (CGP‐57148) by Beran M (1998)
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{'key': 'e_1_2_5_6_2', 'first-page': '2177', 'article-title': 'Imatinib mesylate for Philadelphia chromosome‐positive, chronic‐phase myeloid leukemia after failure of interferon‐alpha: follow‐up results', 'volume': '8', 'author': 'Kantarjian HM', 'year': '2002', 'journal-title': 'Clin Cancer Res.'} / Clin Cancer Res. / Imatinib mesylate for Philadelphia chromosome‐positive, chronic‐phase myeloid leukemia after failure of interferon‐alpha: follow‐up results by Kantarjian HM (2002)
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Dates

Type	When
Created	21 years, 8 months ago (Dec. 18, 2003, 4:01 a.m.)
Deposited	1 year, 10 months ago (Oct. 10, 2023, 10:46 p.m.)
Indexed	3 months ago (June 5, 2025, 2:45 a.m.)
Issued	21 years, 9 months ago (Nov. 18, 2003)
Published	21 years, 9 months ago (Nov. 18, 2003)
Published Online	21 years, 9 months ago (Nov. 18, 2003)
Published Print	21 years, 8 months ago (Jan. 1, 2004)

Funders 0

None

BibTeX

@article{Sneed_2003, title={The significance of myelosuppression during therapy with imatinib mesylate in patients with chronic myelogenous leukemia in chronic phase}, volume={100}, ISSN={1097-0142}, url={http://dx.doi.org/10.1002/cncr.11863}, DOI={10.1002/cncr.11863}, number={1}, journal={Cancer}, publisher={Wiley}, author={Sneed, Thomas B. and Kantarjian, Hagop M. and Talpaz, Moshe and O’Brien, Susan and Rios, Mary Beth and Bekele, B. Nebiyou and Zhou, Xian and Resta, Debra and Wierda, William and Faderl, Stefan and Giles, Francis and Cortes, Jorge E.}, year={2003}, month=nov, pages={116–121} }

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  "abstract": "<jats:title>Abstract</jats:title><jats:sec><jats:title>BACKGROUND</jats:title><jats:p>Imatinib mesylate induces high rates of hematologic and cytogenetic response in patients with chronic myelogenous leukemia (CML). During therapy with imatinib, up to 45% of patients with CML reportedly experience myelosuppression \u2265 Grade 3, requiring interruption of therapy and/or dose reductions. The significance of myelosuppression for response to imatinib is unknown.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>The authors analyzed 143 patients with late chronic\u2010phase CML who were treated with imatinib after failing interferon. Univariate and multivariate analyses were performed to determine patient characteristics that were correlated with myelosuppression response and the association between myelosuppression and cytogenetic response.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>Neutropenia \u2265 Grade 3 (according to National Cancer Institute Common Toxicity Criteria) occurred in 64 patients (45%), and thrombocytopenia \u2265 Grade 3 occurred in 31 patients (22%). Any myelosuppression \u2265 Grade 3 was associated with a lower rate of major (<jats:italic>P</jats:italic> = 0.04) or complete (<jats:italic>P</jats:italic> = 0.01) cytogenetic responses. This was more pronounced with myelosuppression that lasted &gt; 2 weeks. The major cytogenetic response rate was 58% with Grade \u2265 3 myelosuppression compared with a rate of 75% without Grade \u22653 myelosuppression (<jats:italic>P</jats:italic> = 0.03); the complete cytogenetic response rates were 36% and 63%, respectively (<jats:italic>P</jats:italic> = 0.001). In a multivariate analysis, pretreatment platelet count, imatinib dose reductions, and duration of myelosuppression were associated significantly with response.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>Myelosuppression is an independent adverse factor for achieving cytogenetic response with imatinib in patients with CML. Intervention with hematopoietic growth factors in patients with CML who are treated with imatinib should be investigated. Cancer 2004;100:116\u201321. \u00a9 2003 American Cancer Society.</jats:p></jats:sec>",
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