Highlights from

ASH 2020

62nd Annual Meeting & Exposition of the American Society of Hematology

Virtual 5 - 8 December 2020

Long term outcomes associated with imatinib

Analysis of patients with chronic myeloid leukaemia (CML) in Poland treated with imatinib as first-line therapy demonstrated continued efficacy of imatinib. The long-term survival of patients with CML is now approaching that of the general population. The associated rate of late toxic effects is very low.

Imatinib is a tyrosine kinase inhibitor (TKI) that was first approved by the FDA for treatment of CML in 2001. Dr Elzbieta Szczepanek (Jagiellonian University Medical College, Poland) and colleagues retrospectively analysed the long-term outcomes of 267 patients with CML treated with imatinib at their centre since it was first approved [1].

At the time of the analysis, 99 (37.1%) of 267 patients remained on a median dose of 400 mg of imatinib. The remaining 168 patients had discontinued imatinib permanently, citing intolerance and disease progression as the most common reasons. The median time to discontinuation of imatinib due to intolerance was 2 years. Of the 168 patients who discontinued imatinib, 123 switched to second generation TKIs.

The overall survival rate for patients who remained on imatinib for 15 years was 80.2%, and 64.1% for 18 years of treatment. Intention-to-treat analysis for the 99 patients on long-term therapy was performed at 3 months, 12 months, 18 months, 5 years, 10 years, and 15 years. The overall best response rates at any time were: major cytogenetic response, 4%; complete cytogenetic response, 5%; major molecular response, 11%; molecular response grade 4, 14%; molecular response grade 4.5, 9%, and complete molecular response, 50%.

In examining adverse events, 22 patients (8.2%) experienced a cardiovascular event, and 42 (15.7%) suffered a renal event. Haematologic events were documented in 43 (16.1%) of the patients, and “other” adverse events in 189 (70.8%) patients. There were 28 deaths.

  1. Szczepanek E, et al. Long-term Outcomes of Imatinib Real-Life Treatment for Chronic Myeloid Leukemia – a 20-Year Review. 62nd ASH Annual Meeting, 5-8 December 2020. Abstract 1244.

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