Author:
Specchia Giorgina,Pregno Patrizia,Breccia Massimo,Castagnetti Fausto,Monagheddu Chiara,Bonifacio Massimiliano,Tiribelli Mario,Stagno Fabio,Caocci Giovanni,Martino Bruno,Luciano Luigiana,Pizzuti Michele,Gozzini Antonella,Scortechini Anna Rita,Albano Francesco,Bergamaschi Micaela,Capodanno Isabella,Patriarca Andrea,Fava Carmen,Rege-Cambrin Giovanna,Sorà Federica,Galimberti Sara,Bocchia Monica,Binotto Gianni,Reddiconto Giovanni,DiTonno Paolo,Maggi Alessandro,Sanpaolo Grazia,De Candia Maria Stella,Giai Valentina,Abruzzese Elisabetta,Miggiano Maria Cristina,La Barba Gaetano,Pietrantuono Giuseppe,Guella Anna,Levato Luciano,Mulas Olga,Saccona Fabio,Rosti Gianantonio,Musto Pellegrino,Di Raimondo Francesco,Pane Fabrizio,Baccarani Michele,Saglio Giuseppe,Ciccone Giovannino
Abstract
An observational prospective study was conducted by the CML Italian network to analyze the role of baseline patient characteristics and first line treatments on overall survival and CML-related mortality in 1206 newly diagnosed CML patients, 608 treated with imatinib (IMA) and 598 with 2nd generation tyrosine kinase inhibitors (2GTKI). IMA-treated patients were much older (median age 69 years, IQR 58-77) than the 2GTKI group (52, IQR 41-63) and had more comorbidities. Estimated 4-year overall survival of the entire cohort was 89% (95%CI 85.9-91.4). Overall, 73 patients (6.1%) died: 17 (2.8%) in the 2GTKI vs 56 (9.2%) in the IMA cohort (adjusted HR=0.50; 95% CI=0.26-0.94), but no differences were detected for CML-related mortality (10 (1.7%) vs 11 (1.8%) in the 2GTKIs vs IMA cohort (sHR=1.61; 0.52-4.96). The ELTS score was associated to CML mortality (high risk vs low, HR=9.67; 95%CI 2.94-31.74; p<0.001), while age (per year, HR=1.03; 95%CI 1.00-1.06; p=0.064), CCI (4-5 vs 2, HR=5.22; 95%CI 2.56-10.65; p<0.001), ELTS score (high risk vs low, HR=3.11; 95%CI 1.52-6.35, p=0.002) and 2GTKI vs IMA (HR=0.26; 95%CI 0.10-0.65, p=0.004) were associated to an increased risk of non-related CML mortality. The ELTS score showed a better discriminant ability than the Sokal score in all comparisons.