CHRONIC MYELOID LEUKEMIA: EPIDEMIOLOGY AND FIFTEENTH YEARS OF THERAPY IN THE NOVOSIBIRSK REGION

Author: Lyamkina A.S.¹, Maslova L.M.², Naumenko O.V.³, Melnichenko E.V.⁴, Obgolts Yu.N.⁵, Loginova A.B.⁶, Daragan E.V.⁷, Nechunaeva I.N.⁸, Vorontsova E.V.⁹, Shpagina L.A.¹⁰, Yudanov A.V.¹¹, Khalzov K.V.¹², Pospelova T.I.¹³

Author Affiliations

Abstract

The incidence of chronic myeloid leukemia from 2004 to 2018 amounted to 0.63 per 100 000 people per year. The prevalence of chronic myeloid leukemia over the past 15 years has increased from 1.88 to 7.02 case per 100 000 people. We have analyzed the therapy outcomes of chronic myeloid leukemia of patients, received imatinib treatment for more than 12 month (165 patients). Complete hematologic response is attained in 88.5 % cases (146 patients), complete cytogenetic response (CCR) (ph+<0 %) – in 72.1 % cases (119 patients), major molecular response (MMR) – in 50.3 % cases (83 patients). The primary resistance to imatinib is observed in 21.8 % cases (36 patients), secondary – in 6.1 % cases (10 patients – 7 patients have lost the complete hematologic response and CCR and 3 patients have lost the CCR and MMR). The thirteen patients of those, who have primary or secondary resistance to imatinib have been treated with second-generation tyrosine kinase inhibitors (nilotinib, dasatinib) and in 93,3 % cases (14 patients) CCR have been obtained, 10 patients (66.7 %) have attained the CCR and 9 patients (60 %) have achieved MMR. Among all those patients treated with I and II generations tyrosine kinase inhibitors, we have carried out the overall survival (OS) analysis and obtained following results: the median of OS have not been achieved, 5-year OS rate is estimated as 90 %, 10-year OS rate – more than 77 %, calculated 15-year OS – more than 60 %.

Key words

chronic myeloid leukemia, epidemiology, complete cytogenetic response, major molecular response, survival

References

Alsobhi E., Abrar M.B., Abdelaal M., Alsaeed A., Absi A., Alzahrani Z., El-Hemaidi I., Alshehri M.A., Warsi A., Bayashoot S., Hashem H, Merdad A., Radi S., Shiekhi H., Al-Amri A. Response to imatinib therapy in adult patients with chronic myeloid leukemia in Saudi population: a single-center study. Leuk. Lymphoma. 2015; 56 (4): 882-886. doi: 10.3109/10428194.2014.935365

Apperley J.F. Part I: Mechanisms of resistance to imatinib in chronic myeloid leukaemia. Lancet Oncol. 2007; 8: 1018-1029. doi: 10.1016/S1470-2045(07)70342-X

Apperley J.F.: Part II: Management of resistance to imatinib in chronic myeloid leukemia. Lancet Oncol. 2007; 8: 1116-1129. doi: 10.1016/S1470-2045(07)70379-0

Baccarani M., Deininger M.W., Rosti G., Hochhaus A., Soverini S., Apperley J.F., Cervantes F., Clark R.E., Cortes J.E., Guilhot F., Hjorth-Hansen H., Hughes T.P., Kantarjian H.M., Kim D.-W., Larson R.A., Lipton J.H., Mahon F.-X., Martinelli G., Mayer J., Müller M.C., Niederwieser D., Pane F., Radich J.P., Rousselot Ph., Saglio G., Saußele S., Schiffer Ch., Silver R., Simonsson B., Steegmann J.-L., Goldman J.M., Hehlmann R. European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013. Blood. 2013; 122: 872-884. doi: 10.1182/blood-2013-05-501569

Gambacorti C., Talpaz M., Sawyers C.L., Druker B.J., Hochhaus A., Schiffer C.A., Guilhot F., Niederwieser D.W., Stone R.M., Goldman J.M., Mone M., Krahnke T., Gathmann I., Kantarjian H.M. Five year follow-up results of a phase II trial in patients with late chronic phase (L-CP) chronic myeloid leukemia (CML) treated with Imatinib who are refractory/intolerant of interferon-α. Blood. 2005; 106 (11): 1089. doi: 10.1182/blood.V106.11.1089.1089

Golenkov A.K., Vysotskaya L.L., Trifonova E.V., Mitina T.A., Lutskaya T.D., Kataeva E.V., Dudina G.A., Chernykh Yu.B., Buravtsova I.V., Gurov A.N., Gorenkov R.V. The effectiveness of treatment of patients with chronic myelogenous leukemia imatinib in wide clinical practice. Onkogematologiya = Oncohematology. 2012; (3): 17-21. [In Russian].

Hasford J., Baccarani M, Hoffmann V., Guilhot J., Saussele S., Rosti G., Guilhot F., Porkka K., Ossenkoppele G., Lindoerfer D., Simonsson B., Pfirrmann M., Hehlmann R. Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: the EUTOS score. Blood. 2011; 118 (3): 686-692. doi: 10.1182/blood-2010-12-319038

Hehlmann R. Innovation in hematology. Perspectives: CML 2016. Haematologica. 2016; 101 (6): 657-659. doi: 10.3324/haematol.2016.142877

Hochhaus A., Baccarani M., Deininger M., Apperley J.F., Lipton J.H., Goldberg S.L., Corm S., Shah N.P., Cervantes F., Silver R.T., Niederwieser D., Stone R.M., Dombret H., Larson R.A., Roy L., Hughes T., Müller M.C., Ezzeddine R., Countouriotis A.M., Kantarjian H.M. Dasatinib induces durable cytogenetic responses in patients with chronic myelogenous leukemia in chronic phase with resistance or intolerance to imatinib. Leukemia. 2008; 22: 1200-1206. doi: 10.1038/leu.2008.84

Hoffmann V.S., Baccarani M., Hasford J., Lindoerfer D., Burgstaller S., Sertic D., Costeas P., Mayer J., Indrak K., Everaus H., Koskenvesa P., Guilhot J., Schubert-Fritschle G., Castagnetti F., Di Raimondo F., Lejniece S., Griskevicius L., Thielen N., Sacha T., Hellmann A., Turkina A.G., Zaritskey A., Bogdanovic A., Sninska Z., Zupan I., Steegmann J.L., Simonsson B., Clark R.E., Covelli A., Guidi G., Hehlmann R.. The EUTOS population-based registry: incidence and clinical characteristics of 2904 CML patients in 20 European countries. Leukemia. 2015; 29 (6): 1336–1343. doi: 10.1038/leu.2015.73

Hughes T., Deininger M., Hochhaus A., Branford S., Radich J., Kaeda J., Baccarani M., Cortes J., Cross N.C., Druker B.J., Gabert J., Grimwade D., Hehlmann R., Kamel-Reid S., Lipton J.H., Longtine J., Martinelli G., Saglio G., Soverini S., Stock W., Goldman J.M. Monitoring CML patients responding to treatment with tyrosine kinase inhibitors: review and recommendations for harmonizing current methodology for detecting BCR-ABL transcripts and kinase domain mutations and for expressing results. Blood. 2006; 108 (1): 28–37.

Kantarjian H., O'Brien S., Garcia-Manero G., Faderl S., Ravandi F., Jabbour E., Shan J., Cortes J. Very long-term follow-up results of imatinib mesylate therapy in chronic phase chronic myeloid leukemia after failure of interferon alpha therapy. Cancer. 2012; 118 (12): 3116-3122. doi: 10.1002/cncr.26568

Kantarjian H.M., Giles F., Gattermann N., Bhalla K., Alimena G., Palandri F., Ossenkoppele G.J., Nicolini F.E., O'Brien S.G., Litzow M., Bhatia R., Cervantes F., Haque A., Shou Y., Resta D.J., Weitzman A., Hochhaus A., le Coutre P. Nilotinib (AMN107), a highly selective BCR-ABL tyrosine kinase inhibitor, is effective in patients with Philadelphia chromosome–positive chronic myelogenous leukemia in chronic phase following imatinib resistance and intolerance. Blood. 2007; 110: 3540-3546.

Kulikov S.M., Vinogradova O.Yu., Chelysheva E.Yu, Tishchenko I.A., Galaiko M.A., Lazareva O.V., Senderova O.M., Pepelyaeva V.M., Meresiy S.V., Luchinin A.S., Ovsepyan V.A., Milyutina G.I., Gavrilova L.V., Avdeeva L.B., Neverova A.L., Turkina A.G. The incidence of chronic myeloid leukemia in 6 regions of Russia according to a population-based study of 2009–2012. Terapevticheskiy arkhiv = Therapeutic archive. 2014; 86 (7): 24–30. [In Russian].

Lazareva O.V., Turkina A.G., Chelysheva E.Yu., Tishchenko I.A., Galayko M.A., Senderova O.M., Pepelyaeva V.M., Meresii S.V., Luchinin A.S., Milyutina G.I., Gavrilova L.V., Avdeeva L. .B., Vinogradova O.Yu. , Kulikov S.M. Clinical and hematological characteristics of patients with chronic myeloid leukemia in modern conditions: results of the Russian part of the international multicenter prospective population study EUTOS Population-based CML Study. Klinicheskaya onkogematologiya = Clinical oncohematology. 2017; 10 (1): 65–74. [In Russian]. doi: 10.21320/2500-2139-2017-10-1-65-74

Nakamae H., Fujisawa S., Ogura M., Uchida T., Onishi Y., Taniwaki M., Utsunomiya A., Matsue K., Takamatsu Y., Usuki K., Tanimoto M., Ishida Y., Ohashi K., Li L., Miyoshi M.. Dasatinib versus imatinib in Japanese patients with newly diagnosed chronic phase chronic myeloid leukemia: a subanalysis of the DASISION 5-year final report. Int. J. Hematol. 2017; 105(6):792-804. doi: 10.1007/s12185-017-2208-2

Smeding C., Szydło A., Pieluszczak K., Grzeszkiewicz K., Pawelec K. Efficacy and safety of imatinib in paediatric CML – a single centre study. In Vivo. 2019; 33: 869-875. doi: 10.21873/invivo.11552

Sokal J.E., Cox E.B., Baccarani M., Tura S., Gomez G.A., Robertson J.E., Tso C.Y., Braun T.J., Clarkson B.D., Cervantes F. Prognostic discrimination in "good-risk" chronic granulocytic leukemia. Blood. 1984; 63: 789 - 799.

Turkina A.G., Golenkov A.K., Napso L.I. Krylova I.V., Klitochenko T.Yu., Senderova O.M., Kim N.P. Russian registry for the treatment of chronic myeloid leukemia in a routine clinical practice: the results of many years of work. Effektivnaya farmakoterapiya = Effective pharmacotherapy. 2015; (10): 10–15. [In Russian].

Turkina A.G., Horoshko N.D. Practical recommendations for the treatment of patients with chronic myelogenous leukemia. Moscow, 2008. 3-6. [In Russian].

Volkova M.A. New possibilities in the therapy of chronic myelogenous leukemia: dasatinib. Klinicheskaya onkogematologiya = Clinical oncohematology. 2008; 1 (3): 218-226. [In Russian].

Zaritsky A.Yu., Lomaia E.G., Vinogradova O.Yu., Druzhkova G.A., Kolosheinova T.I., Loria S.S., Pospelova T.P., Krylova I.V., Krugloe S.S., Kuznetsov S.V., Chelysheva E.Yu., Abakumov E .M., Sokolova M.A., Pemchenko I.S., Zakharova E.S., Goryacheva S.R., Kolosova L.Yu., Vakhrusheva M.V., Lyamkina A.S., Chernova O.A. ., Machyulaytene E.R., Ivanova V.L., Udaleva V.Yu., Schneider T.V., Ogorodikova Yu.S., Zhuravlev V.S., Zakharova A.V., Martinkevich I.S., Domracheva E.V., Afanasyev B.V., Abdulkadyrov K.M., Kovaleva L.G., Khoroshko P.D., Turkina A.G. Prognosis factors in the treatment of imatinib mesylate in patients in the chronic phase of Ph-positive chronic myelogenous leukemia: data from a multicenter, non-randomized study in Russia. Terapevticheskiy arkhiv = Therapeutic archive. 2007; 79 (8): 17-22. [In Russian].

About Authors (Correspondence):

Lyamkina A.S., e-mail: anna_lyam@mail.ru

Full Text

snmzh_1-2020_lyamkina_i_dr.pdf

Received: 03/03/2020

Accepted: 03/03/2020