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Multicenter Study
. 2016 Sep;18(9):536-40.
doi: 10.1016/j.neo.2016.07.005.

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

Roberto Latagliata  1 , Fabio Stagno  2 , Mario Annunziata  3 , Elisabetta Abruzzese  4 , Alessandra Iurlo  5 , Attilio Guarini  6 , Carmen Fava  7 , Antonella Gozzini  8 , Massimiliano Bonifacio  9 , Federica Sorà  10 , Sabrina Leonetti Crescenzi  11 , Monica Bocchia  12 , Monica Crugnola  13 , Fausto Castagnetti  14 , Isabella Capodanno  15 , Sara Galimberti  16 , Costanzo Feo  17 , Raffaele Porrini  18 , Patrizia Pregno  19 , Manuela Rizzo  20 , Agostino Antolino  21 , Endri Mauro  22 , Nicola Sgherza  23 , Luigiana Luciano  24 , Mario Tiribelli  25 , Antonella Russo Rossi  26 , Malgorzata Trawinska  4 , Paolo Vigneri  27 , Massimo Breccia  28 , Gianantonio Rosti  14 , Giuliana Alimena  28
Affiliations
Multicenter Study

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

Roberto Latagliata et al. Neoplasia. 2016 Sep.

Abstract

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.

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Figures

Figure 1
Figure 1
Dose modifications at different time points.
Figure 2
Figure 2
Cumulative EFS (A) and OS (B).
See this image and copyright information in PMC

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