[Clinical Characteristics and Survival Analysis of Single Center Adult Chronic Myeloid Leukemia in Chronic Phase]
Xia-Xia Jiao1, Yuan-Yuan Zhang1, Jing Pan1
1Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai 201400, China.
Insights
Older adults (≥60 years) with chronic myeloid leukemia in chronic phase (CML-CP) experience fewer benefits from tyrosine kinase inhibitor (TKI) treatment and more adverse reactions compared to younger patients.
Area of Science:
- Hematology
- Oncology
- Clinical Medicine
Context:
- Chronic myeloid leukemia in chronic phase (CML-CP) is a myeloproliferative neoplasm.
- Age is a significant factor influencing treatment outcomes in CML-CP.
- Understanding age-related differences in CML-CP is crucial for optimizing patient care.
Purpose:
- To investigate the clinical characteristics and prognosis of adult CML-CP patients.
- To compare the outcomes of CML-CP patients <60 years versus ≥60 years.
- To evaluate the efficacy and safety of tyrosine kinase inhibitor (TKI) therapy in different age groups.
Summary:
- Retrospective analysis of 41 adult CML-CP patients revealed distinct characteristics in older adults (≥60 years).
- Older patients presented with more comorbidities, higher risk scores, and myelofibrosis at diagnosis.
- Reduced-dose imatinib was more common in older patients, who also showed lower rates of molecular remission and higher incidence of non-hematologic adverse reactions to TKIs.
Impact:
- Age significantly impacts TKI treatment efficacy and safety in CML-CP.
- Older CML-CP patients may require tailored treatment strategies to mitigate risks and improve outcomes.
- This study highlights the need for age-specific considerations in managing CML-CP.
Objective:
To investigate the clinical characteristics and prognosis of single center adult chronic myeloid leukemia in chronic phase (CML-CP).
Methods:
Clinical data of 41 adult CML-CP patients in Department of Hematology, Shanghai Fengxian District Central Hospital from January 2015 to May 2021 were retrospectively analyzed. The clinical characteristics and prognosis of patients between <60 years group and ≥60 years group were compared.
Results:
The 41 patients included 27 (65.9%) males and 14 (34.1%) females. The median age of the patients was 56(19-84) years, with 22 cases (53.7%) <60 years and 19 cases (46.3%) ≥60 years. Univariate analysis indicated that the proportions of patients with comorbidities, intermediate/high-risk Sokal score, myelofibrosis, and lactate dehydrogenase ≥1 000 U/L were significantly increased in ≥60 years group compared with <60 years group at initial diagnosis (all P <0.05). There were no statistical differences in the distribution of sex, ELST score, white blood cell count, platelet count, peripheral blood basophil percentage, peripheral blood eosinophil percentage and bone marrow primitive cell percentage between the two groups (P >0.05). The proportion of patients taking reduced-dose imatinib in ≥60 years group significantly increased (P <0.001). Patients <60 years had a higher proportion of molecular biological remission after treatment of tyrosine kinase inhibitors (TKIs) than patients ≥60 years (P <0.001). The incidence of non-hematologic adverse reactions to TKI therapy significantly increased in patients ≥60 years (P <0.001). Multivariate analysis showed that no adverse factors affecting the efficacy and prognosis of TKI.
Conclusion:
Compared with adult CML-CP patients <60 years, patients ≥60 years gain fewer benefits from TKI treatment and increased adverse reactions.
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