PMID- 34052176 OWN - NLM STAT- MEDLINE DCOM- 20220128 LR - 20220128 IS - 2152-2669 (Electronic) IS - 2152-2669 (Linking) VI - 21 IP - 8 DP - 2021 Aug TI - Efficacy and Safety of Imatinib Treatment in Elderly Patients With Chronic Myeloid Leukemia: Real-Life Data and a Single-Center Experience. PG - 549-557 LID - S2152-2650(21)00148-8 [pii] LID - 10.1016/j.clml.2021.04.005 [doi] AB - BACKGROUND: In the era of tyrosine kinase inhibitors (TKIs), chronic myeloid leukemia (CML) patients generally live close to a normal lifespan, and the number of elderly patients with CML with comorbidities is increasing. PATIENTS AND METHODS: We retrospectively compared the efficacy and safety of frontline imatinib between elderly patients (>/=60 years old) and younger patients (<60 years old) with CML. RESULTS: The study included 33 elderly and 125 younger patients. Elderly patients had significantly higher Charlson comorbidity index (CCI) scores. Efficacy and toxicity were comparable among the older patients with CCI scores of 0 and >/=1. There were significantly more hematologic adverse events (AEs) in elderly patients (P = .005). Although not significant, nonhematologic AEs were also more common in older cases (P = .056). Elderly patients had significantly higher rates of imatinib dose reduction (P < .001). Cumulative response rates were similar in both groups. Event-free survival was comparable, and overall survival (OS)-when non-CML-related deaths were censored-was also similar. In the multivariate analysis, age at diagnosis and CCI were associated with OS, and patients >/= 60 years of age had a 5.998-times higher risk of death compared with the patients < 60 years of age (P = .011). Similarly, patients with CCI scores >/= 2 had a 3.758-times higher risk of death compared with patients with a CCI score of 0 (P = .033). CONCLUSIONS: Upfront imatinib was generally well tolerated among elderly Turkish patients with CML with non-inferior responses and long-term outcomes when compared with younger patients. Comorbidities can be problematic in elderly patients, and today the survival of patients with CML is determined mostly by comorbidities. CI - Copyright (c) 2021. Published by Elsevier Inc. FAU - Eskazan, Ahmet Emre AU - Eskazan AE AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. Electronic address: emre.eskazan@iuc.edu.tr. FAU - Ozmen, Deniz AU - Ozmen D AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Oztas, Mert AU - Oztas M AD - Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Bektas, Fatih AU - Bektas F AD - Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Bayraktar, Esref Alperen AU - Bayraktar EA AD - Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Sadri, Sevil AU - Sadri S AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Keskin, Dilek AU - Keskin D AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Ozgur Yurttas, Nurgul AU - Ozgur Yurttas N AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Elverdi, Tugrul AU - Elverdi T AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Salihoglu, Ayse AU - Salihoglu A AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Ar, Muhlis Cem AU - Ar MC AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Ongoren, Seniz AU - Ongoren S AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Baslar, Zafer AU - Baslar Z AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Aydin, Yildiz AU - Aydin Y AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. FAU - Soysal, Teoman AU - Soysal T AD - Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey. LA - eng PT - Journal Article DEP - 20210420 PL - United States TA - Clin Lymphoma Myeloma Leuk JT - Clinical lymphoma, myeloma & leukemia JID - 101525386 RN - 0 (Antineoplastic Agents) RN - 0 (Protein Kinase Inhibitors) RN - 8A1O1M485B (Imatinib Mesylate) SB - IM MH - Aged MH - Aged, 80 and over MH - Antineoplastic Agents/*therapeutic use MH - Comorbidity MH - Drug-Related Side Effects and Adverse Reactions MH - Female MH - Humans MH - Imatinib Mesylate/*therapeutic use MH - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis/*drug therapy/epidemiology MH - Male MH - Middle Aged MH - Protein Kinase Inhibitors/*therapeutic use MH - Retrospective Studies MH - Survival Analysis MH - Treatment Outcome MH - Turkey/epidemiology OTO - NOTNLM OT - Age OT - Charlson comorbidity index (CCI) OT - Chronic myeloid leukemia OT - Comorbidity OT - Imatinib EDAT- 2021/05/31 06:00 MHDA- 2022/01/29 06:00 CRDT- 2021/05/30 20:40 PHST- 2021/01/19 00:00 [received] PHST- 2021/04/03 00:00 [revised] PHST- 2021/04/06 00:00 [accepted] PHST- 2021/05/31 06:00 [pubmed] PHST- 2022/01/29 06:00 [medline] PHST- 2021/05/30 20:40 [entrez] AID - S2152-2650(21)00148-8 [pii] AID - 10.1016/j.clml.2021.04.005 [doi] PST - ppublish SO - Clin Lymphoma Myeloma Leuk. 2021 Aug;21(8):549-557. doi: 10.1016/j.clml.2021.04.005. Epub 2021 Apr 20.