Outcomes of Chronic Phase Chronic Myeloid Leukemia after Treatment with Multiple Tyrosine Kinase Inhibitors
Abstract
1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
3.1. Patients’ Characteristics
3.2. Clinical Outcomes
3.3. Outcomes According to First-Line TKI: IM vs. NG-TKI
3.4. Factors Affecting PFS or OS
3.5. TKI Discontinuation
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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n | % | ||
---|---|---|---|
Median Age at Diagnosis, Years (Range) | a 50 (11–88) | ||
Sex | M/F | 105/101 | 51/49 |
Race | African American | 56 | 27.2 |
Asian | 5 | 2.4 | |
Hispanic | 6 | 2.9 | |
White | 106 | 51.5 | |
Others | 3 | 1.5 | |
Unknown or declined | 30 | 14.6 | |
Risk (available, n = 110) | Sokal Low/Intermediate/High | 64/27/19 | 58.2/24.5/17.3 |
Hasford Low/Intermediate/High | 66/38/6 | 60.0/34.5/5.5 | |
EUTOS Low/High | 95/15 | 86.4/13.6 | |
b Additional chromosomal abnormality (available, n = 173) | 12 | 6.9 | |
Number of used TKI | 1 | 76 | 36.9 |
2 | 73 | 35.4 | |
3 | 33 | 16.0 | |
4 | 17 | 8.3 | |
5 | 7 | 3.4 | |
1st-line TKI (n = 206) | IM/DAS/NIL/BOS/PON | 145/43/13/4/1 | 70.4/20.9/6.3/1.9/0.5 |
2nd-line TKI (n = 130) | IM/DAS/NIL/BOS/PON/REB | 28/68/23/9/1/1 | 21.5/52.3/17.7/6.9/0.8/0.8 |
3rd-line TKI (n = 65) | IM/DAS/NIL/BOS/PON | 8/19/21/11/6 | 12.3/29.2/32.3/16.9/9.2 |
4th-line TKI (n = 30) | IM/DAS/NIL/BOS/PON/REB | 4/4/1/9/11/1 | 13.3/13.3/3.3/30.0/36.7/3.3 |
5th-line TKI (n = 10) | DAS/BOS/PON | 3/3/4 | 30.0/30.0/40.0 |
Reason for TKI switch or discontinuation (239 events) | R | c 119 | 49.8 |
I | c 104 | 43.5 | |
O | c 16 | 6.7 | |
Nivolumab | 3 | 1.5 | |
Blinatumomab | 1 | 0.5 | |
Chemotherapy | 12 | 5.8 | |
HSCT | Allogeneic/Autologous | 8/1 | 3.9/0.5 |
dABL domain mutation (n = 72) | Positive | 25 | 34.7 |
n (%) | IM (n = 145) | NG-TKI (n = 61) | p | |
---|---|---|---|---|
Switching TKIs | 93 (64.1) | 37 (60.7) | 0.639 | |
Median follow up, months (range) | 80.9 (1.4–190.1) | 23.6 (1.7–64.6) | 0.000 | |
BCR/ABL1IS at 3 months (n = 111) | ≤10% | 39 (59.1) | 39 (86.7) | 0.003 |
>10% | 27 (40.9) | 6 (13.3) | ||
BCR/ABL1IS at 6 months (n = 106) | <1% | 36 (54.5) | 32 (80.0) | 0.012 |
≥1% | 30 (45.5) | 8 (20.0) | ||
BCR/ABL1 at 1 year (n = 103) | ≤0.1% | 33 (51.6) | 30 (76.9) | 0.013 |
>0.1% | 31 (48.4) | 9 (23.1) | ||
The last BCR/ABL1IS <0.1 | 83 (57.2) | 43 (70.5) | 0.086 | |
Disease progression | 17 (11.7) | 2 (3.3) | 0.066 | |
Death | 9 (6.2) | 2 (3.3) | 0.513 |
TKI | 1 CMR, n (%) | 2 Additional CMR, n (%) | 3 Attempts of TKI Discontinuation, n (%) | 4 TKI Discontinuation, n (%) |
---|---|---|---|---|
1st-line TKI (n = 206) | 69 (33.5) | - | 14 (6.8) | 7 (3.4) |
2nd-line TKI (n = 130) | 52 (40.0) | 41 (31.5) | 7 (5.4) | 5 (3.8) |
3rd-line TKI (n = 65) | 18 (27.7) | 8 (12.3) | 1 (1.5) | 1 (1.5) |
4th-line TKI (n = 30) | 8 (26.7) | 5 (16.7) | 3 (10.0) | 1 (3.3) |
5th-line TKI (n = 10) | 1 (10.0) | 1 | 0 | 0 (0) |
Total (n = 206) | 124(60.2) | - | 25(12.1) | 14 (6.8) |
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Kong, J.H.; Winton, E.F.; Heffner, L.T.; Gaddh, M.; Hill, B.; Neely, J.; Hatcher, A.; Joseph, M.; Arellano, M.; El-Rassi, F.; et al. Outcomes of Chronic Phase Chronic Myeloid Leukemia after Treatment with Multiple Tyrosine Kinase Inhibitors. J. Clin. Med. 2020, 9, 1542. https://doi.org/10.3390/jcm9051542
Kong JH, Winton EF, Heffner LT, Gaddh M, Hill B, Neely J, Hatcher A, Joseph M, Arellano M, El-Rassi F, et al. Outcomes of Chronic Phase Chronic Myeloid Leukemia after Treatment with Multiple Tyrosine Kinase Inhibitors. Journal of Clinical Medicine. 2020; 9(5):1542. https://doi.org/10.3390/jcm9051542
Chicago/Turabian StyleKong, Jee Hyun, Elliott F. Winton, Leonard T. Heffner, Manila Gaddh, Brittany Hill, Jessica Neely, Angela Hatcher, Meena Joseph, Martha Arellano, Fuad El-Rassi, and et al. 2020. "Outcomes of Chronic Phase Chronic Myeloid Leukemia after Treatment with Multiple Tyrosine Kinase Inhibitors" Journal of Clinical Medicine 9, no. 5: 1542. https://doi.org/10.3390/jcm9051542
APA StyleKong, J. H., Winton, E. F., Heffner, L. T., Gaddh, M., Hill, B., Neely, J., Hatcher, A., Joseph, M., Arellano, M., El-Rassi, F., Kim, A., Khoury, J. H., & Kota, V. K. (2020). Outcomes of Chronic Phase Chronic Myeloid Leukemia after Treatment with Multiple Tyrosine Kinase Inhibitors. Journal of Clinical Medicine, 9(5), 1542. https://doi.org/10.3390/jcm9051542