Differences among young adults, adults and elderly chronic myeloid leukemia patients

• DOI: 10.1093/annonc/mdu490
• Publication Date: 2014-11-01T07:24:04Z
• Authors: F. Castagnetti; G. Gugliotta; M. Baccarani; M. Breccia; G. Specchia; L. Levato; E. Abruzzese; G. Rossi; A. Iurlo; B. Martino; P. Pregno; F. Stagno; A. Cuneo; M. Bonifacio; M. Gobbi; D. Russo; A. Gozzini; M. Tiribelli; A. de Vivo; G. Alimena; M. Cavo; G. Martinelli; F. Pane; G. Saglio; G. Rosti; F. Salvi; M. Pini; P. Leoni; S. Rupoli; P. Galieni; C. Bigazzi; N. Cantore; F. Palmieri; F. Albano; A. Russo Rossi; A. Rambaldi; T. Intermesoli; F. Palandri; N. Testoni; S. Luatti; S. Soverini; I. Iacobucci; M.T. Bochicchio; M. Apolinari; M. Fogli; I. Cervello; A. Capucci; M. Malagola; A. Malpignano; M. Girasoli; E. Angelucci; E. Usala; S. Storti; E. De Biasi; G. Tagariello; R. Sartori; F. Di Raimondo; P. Vigneri; S. Impera; S. Molica; F. Lanza; C. Viganò; M. Grasso; D. Rapezzi; F. Cavazzini; A. Bosi; V. Santini; S.F. Capalbo; G. Spinosa; I. Pierri; M. Bergamaschi; A.M. Carella; A. Bacigalupo; A. De Blasio; F. Ciccone; N. Di Renzo; C. Musolino; S. Russo; A. Cortelezzi; E. Morra; E.M. Pungolino; M. Luppi; R. Marasca; E.M. Pogliani; C. Gambacorti-Pas...; L. Luciano; F. Ferrara; M. Annunziata; G. Latte; D. Noli; G. Rege-Cambrin; C. Fava; G. Semenzato; G. Binotto; F. Fabbiano; D. Turri; S. Siragusa; C. Caracciolo; M. Musso; F. Porretto; F. Aversa; M. Crugnola; M. Cazzola; E. Orlandi; B. Falini; F. Falzetti; G. Visani; A. Isidori; G. Fioritoni; R. Di Lorenzo; D. Vallisa; E. Trabacchi; M. Petrini; S. Galimberti; M. Pizzuti; A. Zaccaria; M. Salvucci; F. Ronco; D. Ielo; F. Merli; P. Avanzini; P. Tosi; A. Merli; P. Musto; V. De Stefano; S. Sica; R. Latagliata; P. De Fabritiis; M. Trawiska; I. Majolino; L. Pacilli; B. Ronci; M. Cedrone; M.C. Petti; F. Pisani; A. Tafuri; E. Montefusco; F. Iuliano; F. Dore; S. Pardini; M. Bocchia; M. Defina; A.M. Liberati; D. Luzzi; M. Boccadoro; D. Ferrero; U. Vitolo; F. Gherlinzoni; E. Calistri; R. Fanin; G. Pizzolo; V. Meneghini; F. Rodighiero; A. D'Emilio
• Keywords: Male; BCR-ABL; Chronic myeloid leukemia; Prognosis; Tyrosine kinase inhibitors; Young adults; Adult; Age Factors; Aged; Aged, 80 and over; Antineoplastic Agents; Female; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Male; Middle Aged; Prospective Studies; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Spleen; Splenomegaly; Young Adult; Oncology; Hematology; Tyrosine kinase inhibitor; Antineoplastic Agent; 0302 clinical medicine; Protein-Tyrosine Kinase; 80 and over; Age Factor; Prospective Studies; Chronic; BCR-ABL; Aged, 80 and over; Leukemia; Chronic myeloid leukemia; Age Factors; Hematology; Middle Aged; Protein-Tyrosine Kinases; Prognosis; 3. Good health; Oncology; Female; BCR-ABL; chronic myeloid leukemia; prognosis; tyrosine kinase inhibitors; young adults; BCR-ABL; chronic myeloid leukemia; prognosis; tyrosine kinase inhibitors; young adults; oncology; hematology; Human; Adult; Prognosi; 610; Protein Kinase Inhibitor; Antineoplastic Agents; chronic myeloid leukemia; bcr-abl1; Tyrosin kinase inhibitor; prognosis; young adults; Young Adult; 03 medical and health sciences; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Humans; BCR-ABL; Chronic myeloid leukemia; Prognosis; Tyrosine kinase inhibitors; Young adults; Adult; Age Factors; Aged; Aged, 80 and over; Antineoplastic Agents; Female; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Male; Middle Aged; Prospective Studies; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Spleen; Splenomegaly; Young Adult; Protein Kinase Inhibitors; Aged; Tyrosine kinase inhibitors; BCR-ABL; Chronic myeloid leukemia; Prognosis; Tyrosine kinase inhibitors; Young adults; Adult; Age Factors; Aged; Aged, 80 and over; Antineoplastic Agents; Female; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Male; Middle Aged; Prospective Studies; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Spleen; Splenomegaly; Young Adult; Hematology; Oncology; Prospective Studie; Young adult; BCR-ABL; Chronic myeloid leukemia; Prognosis; Tyrosine kinase inhibitors; Young adults; Adult; Age Factors; Aged; Aged, 80 and over; Antineoplastic Agents; Female; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Male; Middle Aged; Prospective Studies; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Spleen; Splenomegaly; Young Adult; Medicine (all); Hematology; Oncology; Splenomegaly; BCR-ABL Positive; BCR-ABL, chronic myeloid leukemia, prognosis, tyrosine kinase inhibitors, young adults; BCR-ABL; Chronic myeloid leukemia; Prognosis; Tyrosine kinase inhibitors; Young adults;; Spleen; Young adults; Myelogenous

The incidence of chronic myeloid leukemia (CML) increases with age, but it is unclear how the characteristics of the disease vary with age. In children, where CML is very rare, it presents with more aggressive features, including huge splenomegaly, higher cell count and higher blast cell percentage.To investigate if after childhood the disease maintains or loses these characteristics of aggressiveness, we analyzed 2784 adult patients, at least 18 years old, registered by GIMEMA CML WP over a 40-year period.Young adults (YAs: 18-29 years old) significantly differed from adults (30-59 years old) and elderly patients (at least 60 years old) particularly for the frequency of splenomegaly (71%, 63% and 55%, P < 0.001), and the greater spleen size (median value: 4.5, 3.0 and 1.0 cm, P < 0.001). According to the EUTOS score, that is age-independent, high-risk patients were more frequent among YAs, than among adult and elderly patients (18%, 9% and 6%, P < 0.001). In tyrosine kinase inhibitors-treated patients, the rates of complete cytogenetic and major molecular response were lower in YAs, and the probability of transformation was higher (16%, 5% and 7%, P = 0.011).The characteristics of CML or the host response to leukemia differ with age. The knowledge of these differences and of their causes may help to refine the treatment and to improve the outcome.NCT00510926, NCT00514488, NCT00769327, NCT00481052.