PMID- 26905949
OWN - NLM
STAT- MEDLINE
DCOM- 20160801
LR  - 20181202
IS  - 1873-5835 (Electronic)
IS  - 0145-2126 (Linking)
VI  - 43
DP  - 2016 Apr
TI  - Disease-related mortality exceeds treatment-related mortality in patients with 
      chronic myeloid leukemia on second-line or later therapy.
PG  - 1-8
LID - S0145-2126(16)30016-9 [pii]
LID - 10.1016/j.leukres.2016.02.001 [doi]
AB  - Treatment of newly-diagnosed patients with chronic-phase chronic myeloid leukemia 
      (CP-CML) with tyrosine kinase inhibitors (TKIs) results in near-normal life 
      expectancy. However, CP-CML patients resistant to initial TKIs face a poorer 
      prognosis and significantly higher CML-related mortality. We conducted a 
      systematic literature review to evaluate the specific causes of deaths (diseases 
      progression versus drug-related) in CP-CML patients receiving second- or 
      third-line therapy. We identified eight studies based on our criteria that 
      reported causes of death. Overall, 5% of second-line and 10% of third-line 
      patients died during the study follow-up period. For second-line, (7 studies, 
      n=1926), mortality was attributed to disease progression for 41% of deaths, 2% to 
      treatment-related causes, 3% were treatment-unrelated, and 50% were unspecified 
      adverse events (AEs), not likely related to study drug. In third-line, (2 
      studies, n=144), 71% deaths were attributed to disease progression, 7% 
      treatment-related AEs, 14% treatment-unrelated and 7% unspecified AEs. Annual 
      death rates for second- and third-line therapy were significantly higher than for 
      general population in similar age group. Our findings suggest death attributed to 
      disease progression is approximately 10 times that due to treatment-related AEs 
      in patients with CP-CML receiving second- or third-line therapy. Therefore, the 
      potential benefits of effective treatment for these patients with the currently 
      available TKIs outweigh the risks of treatment-induced AEs.
CI  - Copyright (c) 2016 Elsevier Ltd. All rights reserved.
FAU - Pearson, Edward
AU  - Pearson E
AD  - Baylor University Medical Center, Dallas, TX, USA. Electronic address: 
      Edward.Pearson@baylorhealth.edu.
FAU - McGarry, Lisa
AU  - McGarry L
AD  - ARIAD Pharmaceuticals, Inc., Cambridge, MA, USA. Electronic address: 
      Lisa.McGarry@ariad.com.
FAU - Gala, Smeet
AU  - Gala S
AD  - MKTXS Market Access Solutions, LLC., Raritan, NJ, USA. Electronic address: 
      sgala@mktxs.com.
FAU - Nieset, Christopher
AU  - Nieset C
AD  - ARIAD Pharmaceuticals, Inc., Cambridge, MA, USA. Electronic address: 
      Christopher.Nieset@ariad.com.
FAU - Nanavaty, Merena
AU  - Nanavaty M
AD  - MKTXS Market Access Solutions, LLC., Raritan, NJ, USA. Electronic address: 
      mnanavaty@mktxs.com.
FAU - Mwamburi, Mkaya
AU  - Mwamburi M
AD  - MKTXS Market Access Solutions, LLC., Raritan, NJ, USA. Electronic address: 
      mmwamburi@mktxs.com.
FAU - Levy, Yair
AU  - Levy Y
AD  - Baylor University Medical Center, Dallas, TX, USA. Electronic address: 
      Moshe.Levy@BaylorHealth.edu.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20160222
PL  - England
TA  - Leuk Res
JT  - Leukemia research
JID - 7706787
SB  - IM
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/*mortality/*therapy
MH  - Male
MH  - Survival Rate
OTO - NOTNLM
OT  - Chronic myeloid leukemia
OT  - Chronic phase
OT  - Disease progression
OT  - Mortality
OT  - Treatment-related adverse events
EDAT- 2016/02/26 06:00
MHDA- 2016/08/02 06:00
CRDT- 2016/02/25 06:00
PHST- 2015/12/15 00:00 [received]
PHST- 2016/01/26 00:00 [revised]
PHST- 2016/02/03 00:00 [accepted]
PHST- 2016/02/25 06:00 [entrez]
PHST- 2016/02/26 06:00 [pubmed]
PHST- 2016/08/02 06:00 [medline]
AID - S0145-2126(16)30016-9 [pii]
AID - 10.1016/j.leukres.2016.02.001 [doi]
PST - ppublish
SO  - Leuk Res. 2016 Apr;43:1-8. doi: 10.1016/j.leukres.2016.02.001. Epub 2016 Feb 22.