Summary of 615 patients of chronic myeloid leukemia in Shanghai from 2001 to 2006

Journal of Experimental & Clinical Cancer Research, Mar 2010

Background To retrospectively review the incidence, treatment efficacy, we followed up newly diagnosed chronic myelogenous leukemia (CML) patients residing in Shanghai during 2001-2006. Methods All eligible cases were reviewed with the data of efficacy responses as well as overall survival (OS) and progression-free survival (PFS) time. Results A total of 615 cases entered the study. CML mainly afflicted those aged 40-60 years old and was slightly more frequent in males than females. More than 85% of the patients were in chronic phase (CP) when diagnosed. All patients were divided into four groups based on the main regimens - hydroxyurea, interferon alpha (IFN-α), imatinib, and hemopoietic stem cell transplantation (HSCT). With the median follow-up of 18 months, imatinib treatment induced 92.2% complete hematologic responses, and 64.3% complete cytogenetic responses among CML-CP patients. Overall the therapeutic efficacy in the imatinib group was higher than that in the hydroxyurea or IFN-α group. Meanwhile, in the imatinib group, all response rates of patients in CP were significantly greater than that in accelerated or blastic crisis phase. The patients treated with imatinib also showed the most promising results regarding OS and PFS. Patients receiving HSCT decreased markedly in number with the introduction of imatinib. Conclusions The number of new patients arising in Shanghai increased from 2001 to 2006. There were still patients receiving hydroxyurea and IFN-α. As the first-line regime for CML, imatinib was less administered in Shanghai before, but has received considerable development and great responses since 2003.

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Summary of 615 patients of chronic myeloid leukemia in Shanghai from 2001 to 2006

Journal of Experimental & Clinical Cancer Research Summary of 615 patients of chronic myeloid leukemia in Shanghai from 2001 to 2006 Ai-Hua Wang 0 Yan-Yan Wang 0 Yu Yao 0 Zi-Zhen Xu 0 Li Zhou 0 Li Wang 0 Li Zhang 0 Yu Chen 0 Zhi-Xiang Shen 0 Jiong Hu 0 Jun-Min Li 0 0 Department of Hematology, Ruijin Hospital, Shanghai Institute of Hematology, Shanghai Jiao-Tong University School of Medicine , Shanghai 200025 , China Background: To retrospectively review the incidence, treatment efficacy, we followed up newly diagnosed chronic myelogenous leukemia (CML) patients residing in Shanghai during 2001-2006. Methods: All eligible cases were reviewed with the data of efficacy responses as well as overall survival (OS) and progression-free survival (PFS) time. Results: A total of 615 cases entered the study. CML mainly afflicted those aged 40-60 years old and was slightly more frequent in males than females. More than 85% of the patients were in chronic phase (CP) when diagnosed. All patients were divided into four groups based on the main regimens - hydroxyurea, interferon alpha (IFN-a), imatinib, and hemopoietic stem cell transplantation (HSCT). With the median follow-up of 18 months, imatinib treatment induced 92.2% complete hematologic responses, and 64.3% complete cytogenetic responses among CML-CP patients. Overall the therapeutic efficacy in the imatinib group was higher than that in the hydroxyurea or IFN-a group. Meanwhile, in the imatinib group, all response rates of patients in CP were significantly greater than that in accelerated or blastic crisis phase. The patients treated with imatinib also showed the most promising results regarding OS and PFS. Patients receiving HSCT decreased markedly in number with the introduction of imatinib. Conclusions: The number of new patients arising in Shanghai increased from 2001 to 2006. There were still patients receiving hydroxyurea and IFN-a. As the first-line regime for CML, imatinib was less administered in Shanghai before, but has received considerable development and great responses since 2003. - Introduction Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder associated with chromosomal translocation between chromosomes 9 and 22, which forms a fusion gene of BCR-ABL encoding BCR-ABL fusion protein. The excessive tyrosine kinase activity of this fusion protein activates multiple signal transduction pathways, which leads to malignant transformation [1,2]. Previous therapies for CML consisted of hemopoietic stem cells transplantation (HSCT), interferon alpha (IFN-a)-based treatment, and simple cell reduction treatment with hydroxyurea (HU). Diagnostic and therapeutic strategies for CML have progressed rapidly since the first clinical trial of targeted tyrosine kinase inhibitor imatinib mesylate (STI571, Glivec or Gleevec; Novartis Pharma) was conducted in CML patients in 1998. Currently, imatinib is considered as the first line treatment regimen for CML [3]. Recently, two additional novel kinase inhibitors, dasatinib (BMS354825; Sprycel; Bristol-Myers Squibb) [4] and nilotinib (AMN107, nilotinib; Novartis Pharma) [5], have become available as treatment options for patients who have developed resistance or those who have shown intolerance to imatinib. We retrospectively reviewed 615 primary CML patients administered in Shanghai from 2001 to 2006 in order to evaluate diagnostic and treatment selection criteria and treatment outcomes for CML. Materials and methods This was a retrospective review of local patients initially diagnosed with any stage of CML during the period January 1, 2001 to December 31, 2006. All patients whose records were reviewed were registered with the Shanghai Municipal Center for Disease Control, and validated by one of the 21 hospitals in Shanghai participating in the study. The diagnosis was confirmed by bone marrow biopsy, chromosomal and fusion gene examination. Medical records for all patients were reviewed retrospectively with the follow-up ending on December 31st, 2007. Demographic data, symptoms, diagnosis, treatment, and prognosis data were collected from clinic data, written correspondence, and personal interviews. Hematological response was defined as complete hematological response (CHR) consisting of white blood cell count <10 109/L, platelet count <450 109/L, with no immature granulocytes visible in peripheral blood, peripheral blood basophilic granulocyte <5%, and no extramedullary infiltration. Cytogenetic response was determined by the percentage of cells in metaphase that were positive for the Ph chromosome in bone marrow. Cytogenetic responses, based on analysis of 20 cells in metaphase, were categorized as complete (CCyR, no cells positive for the Ph chromosome) or partial (1 to 35 percent of cells positive for the Ph chromosome). Major cytogenetic response (MCyR) was defined as the combined rate of PCyR + CCyR. Overall survival time (OS) was calculated from the date of diagnosis to the date of (...truncated)


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Ai-Hua Wang, Yan-Yan Wang, Yu Yao, Zi-Zhen Xu, Li Zhou, Li Wang, Li Zhang, Yu Chen, Zhi-Xiang Shen, Jiong Hu, Jun-Min Li. Summary of 615 patients of chronic myeloid leukemia in Shanghai from 2001 to 2006, Journal of Experimental & Clinical Cancer Research, 2010, pp. 20, 29, DOI: 10.1186/1756-9966-29-20