Introduction of Imatinib as First-line Therapy for Chronic Myeloid Leukemia in Cuba
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| Format: | Artículo científico |
| Langue: | en |
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Medical Education Cooperation with Cuba
2011
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| author | Valia Pavón |
| author_facet | Valia Pavón |
| contents | Introduction of Imatinib as First-line Therapy for Chronic Myeloid Leukemia in Cuba Valia Pavón Rafael Gómez Juan C. Jaime Porfirio Hernández Alberto Arencibia Edgardo Espinosa-Martínez Onel M. Ávila Carlos Hernández Alejandro González José Carnot Edgardo Espinosa-Estrada Rosa M. Lam Ana M. Amor Kalia Lavauth Annia Hernández Medicina Cuba Imatinib molecular response cytogenetic response chronic myeloid leukemia INTRODUCTION Chronic myeloid leukemia is the rst malignant disease to be associated with a genetic lesion and is the first leuke-mia to provide a genotype model conducive to targeted molecular therapy. It is a chronic clonal myeloproliferative disorder, originating in a pluripotent stem cell common to all three hematopoietic lineag-es, characterized by overproduction of myeloid cells in all stages of maturation. Approval of the use of imatinib in the United States in 2001 and its introduction in the treatment of chronic myeloid leukemia changed the evolution and prognosis of the disease and began the era of molecu- lar therapy for malignancies. Imatinib is highly effective and causes fewer adverse reactions than earlier treatments based on interferon and hydroxyurea. In Cuba, chronic myeloid leukemia has been treated with interferon since 1998. Starting in 2003, imatinib was gradually introduced for use in newly-diagnosed chronic myeloid leukemia patients. OBJECTIVE Evaluate the use of imatinib as first-line therapy for chronic myeloid leukemia in a group of Cuban patients, based on he- matologic, cytogenetic, and molecular response; overall and event- free survival rates; and most frequency and severity of adverse reactions. METHODS During May 2003 to May 2008, 33 newly-diagnosed chron- ic myeloid leukemia patients (25 adults, 8 children; <6 months from diagnosis) received a single daily oral dose of imatinib 400 mg from the time of study enrollment. Variables used: (1) to evaluate treatment efficacy: hematologic, cytogenetic, and molecular response; overall and event-free survival; and (2) to evaluate safety: presence of adverse re- actions leading to definitive interruption of treatment or death. RESULTS Complete hematologic response occurred in 100% of patients, major cytogenetic response in 90.9%, and complete cytogenetic response in 48.5%. Molecular response occurred in 36.4% of patients. With a mean follow-up of 39 months, overall survival was 96% and estimated five-year event-free survival was 85%. No adverse reactions occurred in 39.5% of patients. Adverse reactions most frequently observed were myelosuppression (24.2%) and digestive disorders (21.2%). These were followed, in decreasing order, by edema, primarily orbital (9.1%), skin depigmentation (3%), and cardiac arrhythmias (3%). CONCLUSIONS In the present study, imatinib was effective first-line therapy for patients with newly-diagnosed chronic myeloid leukemia, as determined by overall and event-free survival rates. No severe ad- verse reactions were observed. 2011 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437542077009 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.1 Vol.13 |
| format | Artículo científico |
| id | redalyc_437542077009 |
| institution | Redalyc |
| language | en |
| publishDate | 2011 |
| publisher | Medical Education Cooperation with Cuba |
| spellingShingle | Introduction of Imatinib as First-line Therapy for Chronic Myeloid Leukemia in Cuba Valia Pavón Medicina Cuba Imatinib molecular response cytogenetic response chronic myeloid leukemia Introduction of Imatinib as First-line Therapy for Chronic Myeloid Leukemia in Cuba Valia Pavón Rafael Gómez Juan C. Jaime Porfirio Hernández Alberto Arencibia Edgardo Espinosa-Martínez Onel M. Ávila Carlos Hernández Alejandro González José Carnot Edgardo Espinosa-Estrada Rosa M. Lam Ana M. Amor Kalia Lavauth Annia Hernández Medicina Cuba Imatinib molecular response cytogenetic response chronic myeloid leukemia INTRODUCTION Chronic myeloid leukemia is the rst malignant disease to be associated with a genetic lesion and is the first leuke-mia to provide a genotype model conducive to targeted molecular therapy. It is a chronic clonal myeloproliferative disorder, originating in a pluripotent stem cell common to all three hematopoietic lineag-es, characterized by overproduction of myeloid cells in all stages of maturation. Approval of the use of imatinib in the United States in 2001 and its introduction in the treatment of chronic myeloid leukemia changed the evolution and prognosis of the disease and began the era of molecu- lar therapy for malignancies. Imatinib is highly effective and causes fewer adverse reactions than earlier treatments based on interferon and hydroxyurea. In Cuba, chronic myeloid leukemia has been treated with interferon since 1998. Starting in 2003, imatinib was gradually introduced for use in newly-diagnosed chronic myeloid leukemia patients. OBJECTIVE Evaluate the use of imatinib as first-line therapy for chronic myeloid leukemia in a group of Cuban patients, based on he- matologic, cytogenetic, and molecular response; overall and event- free survival rates; and most frequency and severity of adverse reactions. METHODS During May 2003 to May 2008, 33 newly-diagnosed chron- ic myeloid leukemia patients (25 adults, 8 children; <6 months from diagnosis) received a single daily oral dose of imatinib 400 mg from the time of study enrollment. Variables used: (1) to evaluate treatment efficacy: hematologic, cytogenetic, and molecular response; overall and event-free survival; and (2) to evaluate safety: presence of adverse re- actions leading to definitive interruption of treatment or death. RESULTS Complete hematologic response occurred in 100% of patients, major cytogenetic response in 90.9%, and complete cytogenetic response in 48.5%. Molecular response occurred in 36.4% of patients. With a mean follow-up of 39 months, overall survival was 96% and estimated five-year event-free survival was 85%. No adverse reactions occurred in 39.5% of patients. Adverse reactions most frequently observed were myelosuppression (24.2%) and digestive disorders (21.2%). These were followed, in decreasing order, by edema, primarily orbital (9.1%), skin depigmentation (3%), and cardiac arrhythmias (3%). CONCLUSIONS In the present study, imatinib was effective first-line therapy for patients with newly-diagnosed chronic myeloid leukemia, as determined by overall and event-free survival rates. No severe ad- verse reactions were observed. 2011 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437542077009 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.1 Vol.13 |
| title | Introduction of Imatinib as First-line Therapy for Chronic Myeloid Leukemia in Cuba |
| topic | Medicina Cuba Imatinib molecular response cytogenetic response chronic myeloid leukemia |
| url | https://www.redalyc.org/articulo.oa?id=437542077009 |