Treatment outcome in a population-based, ‘real-world’ cohort of patients with chronic myeloid leukemia

Inge G.P. Geelen, Noortje Thielen, Jeroen J.W.M. Janssen, Mels Hoogendoorn, Tanja J.A. Roosma, Sten P. Willemsen, Otto Visser, Jan J. Cornelissen, Peter E. Westerweel

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Evaluations of the ‘real-world’ efficacy and safety of tyrosine kinase inhibitors in patients with chronic myeloid leukemia are scarce. A nationwide, population-based, chronic myeloid leukemia registry was analyzed to evaluate (deep) response rates to first and subsequent treatment lines and eligibility for a treatment cessation attempt in adults diagnosed between January 2008 and April 2013 in the Netherlands. The registry covered 457 patients; 434 in chronic phase (95%) and 15 (3%) in advanced disease phase. Seventy-five percent of the patients in chronic phase were treated with imatinib and 25% with a second-generation tyrosine kinase inhibitor. At 3 years 44% of patients had discontinued their first-line treatment, mainly due to intolerance (21%) or treatment failure (19%). At 18 months 73% of patients had achieved a complete cytogenetic response and 63% a major molecular response. Deep molecular responses (MR4.0 and MR4.5) were achieved in 69% and 56% of patients, respectively, at 48 months. All response milestones were achieved faster in patients treated upfront with a second-generation tyrosine kinase inhibitor, but ultimately patients initially treated with imatinib also reached similar levels of responses. The 6-year cumulative incidence of eligibility for a tyrosine kinase cessation attempt, according to EURO-SKI criteria, was 31%. Our findings show that in a ‘real-world’ setting the long-term outcome of patients treated with tyrosine kinase inhibitors is excellent and the conditions for an attempt to stop tyrosine kinase inhibitor therapy are met by a third of the patients.

Original languageEnglish
Pages (from-to)1842-1849
Number of pages8
JournalHaematologica
Volume102
Issue number11
DOIs
Publication statusPublished - 27 Oct 2017

Cite this

Geelen, I. G. P., Thielen, N., Janssen, J. J. W. M., Hoogendoorn, M., Roosma, T. J. A., Willemsen, S. P., ... Westerweel, P. E. (2017). Treatment outcome in a population-based, ‘real-world’ cohort of patients with chronic myeloid leukemia. Haematologica, 102(11), 1842-1849. https://doi.org/10.3324/haematol.2017.174953
Geelen, Inge G.P. ; Thielen, Noortje ; Janssen, Jeroen J.W.M. ; Hoogendoorn, Mels ; Roosma, Tanja J.A. ; Willemsen, Sten P. ; Visser, Otto ; Cornelissen, Jan J. ; Westerweel, Peter E. / Treatment outcome in a population-based, ‘real-world’ cohort of patients with chronic myeloid leukemia. In: Haematologica. 2017 ; Vol. 102, No. 11. pp. 1842-1849.
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abstract = "Evaluations of the ‘real-world’ efficacy and safety of tyrosine kinase inhibitors in patients with chronic myeloid leukemia are scarce. A nationwide, population-based, chronic myeloid leukemia registry was analyzed to evaluate (deep) response rates to first and subsequent treatment lines and eligibility for a treatment cessation attempt in adults diagnosed between January 2008 and April 2013 in the Netherlands. The registry covered 457 patients; 434 in chronic phase (95{\%}) and 15 (3{\%}) in advanced disease phase. Seventy-five percent of the patients in chronic phase were treated with imatinib and 25{\%} with a second-generation tyrosine kinase inhibitor. At 3 years 44{\%} of patients had discontinued their first-line treatment, mainly due to intolerance (21{\%}) or treatment failure (19{\%}). At 18 months 73{\%} of patients had achieved a complete cytogenetic response and 63{\%} a major molecular response. Deep molecular responses (MR4.0 and MR4.5) were achieved in 69{\%} and 56{\%} of patients, respectively, at 48 months. All response milestones were achieved faster in patients treated upfront with a second-generation tyrosine kinase inhibitor, but ultimately patients initially treated with imatinib also reached similar levels of responses. The 6-year cumulative incidence of eligibility for a tyrosine kinase cessation attempt, according to EURO-SKI criteria, was 31{\%}. Our findings show that in a ‘real-world’ setting the long-term outcome of patients treated with tyrosine kinase inhibitors is excellent and the conditions for an attempt to stop tyrosine kinase inhibitor therapy are met by a third of the patients.",
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Geelen, IGP, Thielen, N, Janssen, JJWM, Hoogendoorn, M, Roosma, TJA, Willemsen, SP, Visser, O, Cornelissen, JJ & Westerweel, PE 2017, 'Treatment outcome in a population-based, ‘real-world’ cohort of patients with chronic myeloid leukemia' Haematologica, vol. 102, no. 11, pp. 1842-1849. https://doi.org/10.3324/haematol.2017.174953

Treatment outcome in a population-based, ‘real-world’ cohort of patients with chronic myeloid leukemia. / Geelen, Inge G.P.; Thielen, Noortje; Janssen, Jeroen J.W.M.; Hoogendoorn, Mels; Roosma, Tanja J.A.; Willemsen, Sten P.; Visser, Otto; Cornelissen, Jan J.; Westerweel, Peter E.

In: Haematologica, Vol. 102, No. 11, 27.10.2017, p. 1842-1849.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Roosma, Tanja J.A.

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AU - Visser, Otto

AU - Cornelissen, Jan J.

AU - Westerweel, Peter E.

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