Frontline Dasatinib Treatment in a “Real-Life” Cohort of Patients Older than 65 Years with Chronic Myeloid Leukemia

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• 作者：Roberto Latagliata^* ; ^{rob.lati@libero.it" class="auth_mail" title="E-mail the corresponding author} ; Fabio Stagno^&dagger ; ; Mario Annunziata^&Dagger ; ; Elisabetta Abruzzese^§ ; ; Alessandra Iurlo^¶ ; ; Attilio Guarini^# ; Carmen Fava^** ; Antonella Gozzini^&dagger ; &dagger ; ; Massimiliano Bonifacio^&Dagger ; &Dagger ; ; Federica Sorà ; ^§ ; § ; ; Sabrina Leonetti Crescenzi^¶ ; ¶ ; ; Monica Bocchia^## ; Monica Crugnola^*** ; Fausto Castagnetti^&dagger ; &dagger ; &dagger ; ; Isabella Capodanno^&Dagger ; &Dagger ; &Dagger ; ; Sara Galimberti^§ ; § ; § ; ; Costanzo Feo^¶ ; ¶ ; ¶ ; ; Raffaele Porrini^### ; Patrizia Pregno^**** ; Manuela Rizzo^&dagger ; &dagger ; &dagger ; &dagger ; ; Agostino Antolino^&Dagger ; &Dagger ; &Dagger ; &Dagger ; ; Endri Mauro^§ ; § ; § ; § ; ; Nicola Sgherza^¶ ; ¶ ; ¶ ; ¶ ; ; Luigiana Luciano^#### ; Mario Tiribelli^***** ; Antonella Russo Rossi^&dagger ; &dagger ; &dagger ; &dagger ; &dagger ; ; Malgorzata Trawinska^§ ; ; Paolo Vigneri^&Dagger ; &Dagger ; &Dagger ; &Dagger ; &Dagger ; ; Massimo Breccia^* ; Gianantonio Rosti^&dagger ; &dagger ; &dagger ; ; Giuliana Alimena^*
• 刊名：Neoplasia
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：18
• 期：9
• 页码：536-540
• 全文大小：317 K

文摘

Dasatinib (DAS) has been licensed for the frontline treatment in chronic myeloid leukemia (CML). However, very few data are available regarding its efficacy and toxicity in elderly patients with CML outside clinical trials. To address this issue, we set out a “real-life” cohort of 65 chronic phase CML patients older than 65 years (median age 75.1 years) treated frontline with DAS in 26 Italian centers from June 2012 to June 2015, focusing our attention on toxicity and efficacy data. One third of patients (20/65: 30.7%) had 3 or more comorbidities and required concomitant therapies; according to Sokal classification, 3 patients (4.6%) were low risk, 39 (60.0%) intermediate risk, and 20 (30.8%) high risk, whereas 3 (4.6%) were not classifiable. DAS starting dose was 100 mg once a day in 54 patients (83.0%), whereas 11 patients (17.0%) received less than 100 mg/day. Grade 3/4 hematologic and extrahematologic toxicities were reported in 8 (12.3%) and 12 (18.5%) patients, respectively. Overall, 10 patients (15.4%) permanently discontinued DAS because of toxicities. Pleural effusions (all WHO grades) occurred in 12 patients (18.5%) and in 5 of them occurred during the first 3 months. DAS treatment induced in 60/65 patients (92.3%) a complete cytogenetic response and in 50/65 (76.9%) also a major molecular response. These findings show that DAS might play an important role in the frontline treatment of CML patients >65 years old, proving efficacy and having a favorable safety profile also in elderly subjects with comorbidities.