Management strategy of patients with chronic myeloid leukemia in chronic phase who failed to response to imatinib – Kraków Haematology Clinic experience Original article
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Abstract
Introduction: Tyrosine kinase inhibitors eliminate chronic myeloid leukemia cells in a targeted way. The resistance to this therapy was the cause of development of treatment recommendations and drugs of second and subsequent generations. The management strategy in case of resistance can vary and depends largely on the experience of the treating center.
Aim: A retrospective analysis of second line treatment results of patients with chronic myeloid leukemia in chronic phase showing different intensity of resistance to first line treatment with imatinib.
Materials and methods: 73 patients at the age of 21–80 years were when received second line treatment between 2001 to 2011. Diagnostic tests were performed to control the course of therapy according to the recommendations of ELN. Results: The worst prognosis and treatment results have been reported in patients who, during first line treatment did not achieved or lost complete hematologic response. Prognosis in patients with suboptimal response was better than among patients with primary or secondary resistance. Patients who achieved a major molecular response until 18 months after implementation of first line therapy with imatinib progressed significantly less frequently (2.8% vs 14.1%; p=0.025).
Conclusions: The chances of a good response to second line therapy decreases when the intensity of resistance to first line treatment, and are greatest in those with suboptimal response. Systematic monitoring of treatment may identify a group of patients who most benefit from early treatment modification.
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
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