Prognostic Factors for Overall Survival In Chronic Myeloid Leukemia Patients: A Multicentric Cohort Study by the Italian CML GIMEMA Network

• DOI: 10.3389/fonc.2021.739171
• Publication Date: 2021-08-27T21:02:05Z
• Authors: Giorgina Specchia; Patrizia Pregno; Massimo Breccia; Fausto Castagnetti; Chiara Monagheddu; Massimiliano Boni...; Mario Tiribelli; Fabio Stagno; Giovanni Caocci; Bruno Martino; Luigiana Luciano; Michele Pizzuti; Antonella Gozzini; Anna Rita Scortec...; Francesco Albano; Micaela Bergamaschi; Isabella Capodanno; Andrea Patriarca; Carmen Fava; Giovanna Rege-Cam...; Federica Sorà; Sara Galimberti; Monica Bocchia; Gianni Binotto; Giovanni Reddiconto; Paolo DiTonno; Alessandro Maggi; Grazia Sanpaolo; Maria Stella De C...; Valentina Giai; Elisabetta Abruzzese; Maria Cristina Mi...; Gaetano La Barba; Giuseppe Pietrant...; Anna Guella; Luciano Levato; Olga Mulas; Fabio Saccona; Gianantonio Rosti; Pellegrino Musto; Francesco Di Raim...; Fabrizio Pane; Michele Baccarani; Giuseppe Saglio; Giovannino Ciccone
• Keywords: ELT; chronic myeloid leukemia; tyrosine kinase inhibitors; prognosticfactors; ELTs; Sokal score; chronic myeloid leukemia; ELTs; prognostic factors; Sokal score; tyrosine kinase inhibitors; 610; prognostic factors; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; 3. Good health; prognostic factors for overall survival in chronic myeloid leukemia patient a multicentric cohort study; 03 medical and health sciences; 0302 clinical medicine; Oncology; chronic myeloid leukemia; tyrosine kinase inhibitors; prognostic factor; Sokal score; ELTs; RC254-282

An observational prospective study was conducted by the CML Italian network to analyze the role of baseline patient characteristics and first line treatments on overall survival and CML-related mortality in 1206 newly diagnosed CML patients, 608 treated with imatinib (IMA) and 598 with 2nd generation tyrosine kinase inhibitors (2GTKI). IMA-treated patients were much older (median age 69 years, IQR 58-77) than the 2GTKI group (52, IQR 41-63) and had more comorbidities. Estimated 4-year overall survival of the entire cohort was 89% (95%CI 85.9-91.4). Overall, 73 patients (6.1%) died: 17 (2.8%) in the 2GTKI vs 56 (9.2%) in the IMA cohort (adjusted HR=0.50; 95% CI=0.26-0.94), but no differences were detected for CML-related mortality (10 (1.7%) vs 11 (1.8%) in the 2GTKIs vs IMA cohort (sHR=1.61; 0.52-4.96). The ELTS score was associated to CML mortality (high risk vs low, HR=9.67; 95%CI 2.94-31.74; p<0.001), while age (per year, HR=1.03; 95%CI 1.00-1.06; p=0.064), CCI (4-5 vs 2, HR=5.22; 95%CI 2.56-10.65; p<0.001), ELTS score (high risk vs low, HR=3.11; 95%CI 1.52-6.35, p=0.002) and 2GTKI vs IMA (HR=0.26; 95%CI 0.10-0.65, p=0.004) were associated to an increased risk of non-related CML mortality. The ELTS score showed a better discriminant ability than the Sokal score in all comparisons.