Long-term prognostic impact of the use of erythropoietic-stimulating agents in patients with chronic myeloid leukemia in chronic phase treated with imatinib.

Abstract

BACKGROUND:

Anemia is a frequent side effect of imatinib in patients with chronic myeloid leukemia (CML). Erythropoietic-stimulating agents have been used for treatment of imatinib-induced anemia. There are no data on long-term safety of erythropoietic-stimulating agents in CML patients.

METHODS:

The records of chronic phase CML patients who received treatment with imatinib were reviewed for use of erythropoietic-stimulating agents and occurrence of thrombotic events. Data on cytogenetic response and survival were analyzed by use of erythropoietic-stimulating agent.

RESULTS:

A total of 608 patients were included, and 217 patients received erythropoietic-stimulating agents. There were 30 thrombotic episodes. Patients who received erythropoietic-stimulating agents had a higher rate of thrombosis (8.5% vs 2.6%, P = .0025). There was no difference in cytogenetic response rate and survival by use of erythropoietic-stimulating agent. Development of grade 3-4 anemia occurred in 62 (10%) patients and was associated with significantly worse response and survival in patients in late chronic phase. By multivariate analysis, use of erythropoietic-stimulating agents was not a risk factor for event-free survival.

CONCLUSIONS:

In our cohort of chronic phase CML patients, use of erythropoietic-stimulating agents did not impact survival or cytogenetic response rate, but was associated with a higher thrombosis rate. Severe anemia is associated with worse survival and response.

• Authors: Fabio P S Santos, Yesid Alvarado, Hagop Kantarjian, Dushyant Verma, Susan O'Brien, Gloria Mattiuzzi, Farhad Ravandi, Gautam Borthakur, Jorge Cortes
• Journal: Cancer (Cancer) Vol. 117 Issue 5 Pg. 982-91 (Mar 01 2011) ISSN: 0008-543X [Print] United States
• PMID: 20960502 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2010 American Cancer Society.

Chemical References

• Antineoplastic Agents
• Benzamides
• Hematinics
• Piperazines
• Pyrimidines
• Imatinib Mesylate

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anemia (drug therapy, epidemiology, prevention & control)
• Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
• Benzamides
• Clinical Trials, Phase II as Topic
• Clinical Trials, Phase III as Topic
• Female
• Hematinics (administration & dosage, adverse effects, therapeutic use)
• Humans
• Imatinib Mesylate
• Leukemia, Myeloid, Chronic-Phase (diagnosis, drug therapy, mortality)
• Male
• Middle Aged
• Piperazines (administration & dosage, therapeutic use)
• Polypharmacy
• Prognosis
• Pyrimidines (administration & dosage, therapeutic use)
• Retrospective Studies
• Survival Analysis
• Thrombosis (chemically induced, epidemiology)
• Time Factors
• Treatment Outcome
• Young Adult