Imatinib mesylate therapy improves survival in patients with newly diagnosed Philadelphia chromosome-positive chronic myelogenous leukemia in the chronic phase: comparison with historic data.

Abstract

BACKGROUND:

The International Randomized study of Interferon-alpha plus cytarabine (IFN-alpha plus ara-C) versus STI571 (imatinib mesylate) [IRIS trial] in patients with newly diagnosed Philadelphia chromosome (Ph)-positive, chronic-phase chronic myelogenous leukemia (CML) has not shown (to date) a survival advantage for imatinib. This was most likely because approximately 90% of patients receiving IFN-alpha plus ara-C changed to imatinib therapy after a median of 8 months into therapy.

METHODS:

The authors analyzed the results with imatinib therapy in patients with newly diagnosed Ph-positive CML in chronic phase and compared their outcome with patients who received IFN-alpha regimens. A total of 187 patients with Ph-positive CML in early chronic phase treated with imatinib were compared with a historic group of 650 similar patients treated with IFN-alpha regimens from 1982 until 1997.

RESULTS:

Patients who received imatinib were significantly older and had significantly more bone marrow basophilia and less leukocytosis. The complete cytogenetic response (Ph 0%) rates were better with imatinib (81% vs. 32%; P < 0.001), as were the survival rates (30-month estimated survival rates 98% vs. 88%; P = 0.01). A multivariate analysis of the total study group of 837 patients identified imatinib therapy to be a significant independent favorable prognostic factor for survival (P = 0.01).

CONCLUSIONS:

The current study is the first to indicate the survival advantage of imatinib compared with IFN-alpha, the previous standard of care, in patients with early chronic-phase CML.

• Authors: Hagop M Kantarjian, Susan O'Brien, Jorge Cortes, Francis J Giles, Mary Beth Rios, Jianqin Shan, Stefan Faderl, Guillermo Garcia-Manero, Alessandra Ferrajoli, Srdan Verstovsek, William Wierda, Michael Keating, Moshe Talpaz
• Journal: Cancer (Cancer) Vol. 98 Issue 12 Pg. 2636-42 (Dec 15 2003) ISSN: 0008-543X [Print] United States
• PMID: 14669283 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2003 American Cancer Society.

Chemical References

• Antineoplastic Agents
• Benzamides
• Interferon-alpha
• Piperazines
• Pyrimidines
• Imatinib Mesylate
• Protein-Tyrosine Kinases

Topics

• Administration, Oral
• Antineoplastic Agents (administration & dosage, therapeutic use)
• Benzamides
• Drug Administration Schedule
• Follow-Up Studies
• Humans
• Imatinib Mesylate
• Interferon-alpha (administration & dosage, therapeutic use)
• Leukemia, Myelogenous, Chronic, BCR-ABL Positive (drug therapy, mortality)
• Leukemia, Myeloid, Chronic-Phase (drug therapy, mortality)
• Middle Aged
• Philadelphia Chromosome
• Piperazines (administration & dosage, therapeutic use)
• Prognosis
• Protein-Tyrosine Kinases (antagonists & inhibitors)
• Pyrimidines (administration & dosage, therapeutic use)
• Risk Factors
• Survival Rate
• Treatment Outcome