Discontinuation of imatinib in Japanese patients with chronic myeloid leukemia

Haematologica. 2012 Jun;97(6):903-6. doi: 10.3324/haematol.2011.056853. Epub 2011 Dec 16.

Abstract

It was recently recognized that some chronic myeloid leukemia patients with a complete molecular response could sustain that response after discontinuation of imatinib. To characterize the clinical outcomes and profiles of chronic phase chronic myeloid leukemia patients who could discontinue imatinib, we conducted a nationwide survey in Japan. Among 3,242 imatinib-treated chronic myeloid leukemia patients, we identified 50 who had discontinued imatinib for at least six months; of these we analyzed 43. Molecular recurrence was detected in 19 patients, and a complete molecular response rate was estimated to be 47% following imatinib discontinuation. Based on multivariate regression analysis, imatinib dose intensity and prior interferon-α administration were independently predictive of molecular recurrence within 12 months. The depth of the molecular response should be a factor influencing long-term sustained complete molecular response after discontinuation of imatinib. Additionally, an immunological mechanism modified by interferon-α might control chronic myeloid leukemia stem cells.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use*
  • Benzamides
  • Disease-Free Survival
  • Drug Administration Schedule
  • Female
  • Humans
  • Imatinib Mesylate
  • Immunity, Innate
  • Interferon-alpha / administration & dosage
  • Interferon-alpha / therapeutic use*
  • Japan
  • Leukemia, Myeloid, Chronic-Phase / drug therapy*
  • Leukemia, Myeloid, Chronic-Phase / immunology
  • Leukemia, Myeloid, Chronic-Phase / mortality
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplastic Stem Cells / drug effects*
  • Neoplastic Stem Cells / immunology
  • Piperazines / administration & dosage
  • Piperazines / therapeutic use*
  • Pyrimidines / administration & dosage
  • Pyrimidines / therapeutic use*
  • Recurrence
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Benzamides
  • Interferon-alpha
  • Piperazines
  • Pyrimidines
  • Imatinib Mesylate