Treatment of Consecutive Patients with Chronic Myeloid Leukemia In the Cooperating Centers From the Slovak Republic After 2000 – A Report From the Population Based CAMELIA Registry

Most results on the treatment of chronic myeloid leukemia (CML) with imatinib were obtained from clinical trials that may differ from the routine practice. We report the results of treatment of consecutive CML patients at ten major centers during 2000–2010.

Data reporting was retrospective in 2000– 2004 and prospective from 2005 on. A total of 295 patients (137 women and 158 men; median age 49 [range, 15–81]) with Ph+ CML were registered. The median follow-up was 45.4 months (0–113,5).

Most patients were treated with first- (169; 57.28%) or second-line (84; 28.5%) imatinib, part of patients underwent allogeneic hematopoietic stem cell transplantation (AHSCT) (28; 9,5%), but 4,7 % were treated with other modalities (14 patients; median age 66 [range, 32–83]). The probability of overall survival (OS) according to Kaplan and Meier at five years was 88.9%, 77.5% and 68.7% for chronic phase patients treated with first-, second-line imatinib and first-line AHSCT, respectively, but only 25.2% for patients receiving other modalities. OS was dependent on the disease phase and Sokal, Hasford and EBMT risk scores (p< 0.001; each). Only 46.2% of deaths in patients treated with other modalities were attributable to CML. Elderly patients over 65 years achieved similar response rates and progression-free survival as the younger. There was a trend for inferior results of AHSCT performed after failure of imatinib (p=0.075), probably due to differences in EBMT risk scores (p< 0.001).

Ability to achieve results comparable to previous clinical studies in our CML cohort was influenced by centralized care. Decisions not to initiate imatinib or to delay AHSCT may have a negative impact on OS, but comorbidities may limit the treatment potential of imatinib in the elderly.

No relevant conflicts of interest to declare.