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RESEARCH PRODUCT

Differences among young adults, adults and elderly chronic myeloid leukemia patients

D. IeloMario CazzolaA. De VivoMario PetriniG. FioritoniSimona SicaFausto CastagnettiB. FaliniMiriam FogliAgostino CortelezziC. ViganòGiuliana AlimenaMaurizio MussoG. SpinosaFlavia SalviGiancarlo LatteMichele PizzutiNicola CantoreD. LuzziB. RonciFrancesco MerliMario BoccadoroDiamante TurriMonica BocchiaPatrizia TosiA. M. CarellaSimona LuattiG. SemenzatoMariella GrassoNicoletta TestoniGiovanni MartinelliEster PungolinoGiuseppe TagarielloA. Russo RossiSimona SoveriniFrancesca RoncoFranco IulianoGiovanni RostiAlberto BosiTamara IntermesoliDario FerreroSara GalimbertiGiovanna Rege-cambrinFerdinando PorrettoSabina RussoRoberto LatagliataPellegrino MustoE. MorraAgostino TafuriFranca FalzettiFrancesco CavazziniP. GalieniMarzia SalvucciF. RodighieroStefana ImperaFausto DoreP. De FabritiisV. MeneghiniElisabetta CalistriPaolo VigneriIvana PierriMichele CavoMassimo PiniFabrizio CicconeDomenico RussoE TrabacchiFranco GherlinzoniMichele BaccaraniIlaria IacobucciRoberto SartoriPaolo AvanziniD. NoliRoberto MarascaSimonetta PardiniA. MalpignanoMaria Concetta PettiBruno MartinoM. BergamaschiGiovanni PizzoloValeria SantiniE OrlandiCatia BigazziSerena RupoliGiuseppe SaglioI. CervelloClementina CaraccioloAnna MerliR. Di LorenzoEnrico PoglianiFrancesco LanzaMariella GirasoliM. ApolinariCaterina MusolinoFrancesco FabbianoD. VallisaMario AnnunziataGabriele GugliottaV. De StefanoIgnazio MajolinoSergio StortiP. LeoniAdele CapucciMassimo BrecciaAlessandro IsidoriCarmen FavaGianni BinottoCarlo Gambacorti-passeriniL. PacilliMario TiribelliLuciano LevatoFelicetto FerraraN. Di RenzoAnna D'emilioFrancesco PisaniFabio StagnoMonica CrugnolaM. TrawiskaPatrizia PregnoMarzia DefinaStefano MolicaMario LuppiMichele MalagolaDavide RapezziA. M. LiberatiE. De BiasiA. IurloUmberto VitoloSilvana CapalboMaria Teresa BochicchioF. Di RaimondoFranco AversaGiuseppe VisaniFausto PalmieriAlessandro RambaldiSergio SiragusaMassimiliano BonifacioLuigiana LucianoGiorgina SpecchiaElisabetta AbruzzeseA. De BlasioFrancesco AlbanoAntonio CuneoEmilio UsalaAlfonso ZaccariaR FaninFrancesca PalandriFabrizio PaneEnrico MontefuscoA. GozziniGiulio RossiEmanuele AngelucciA. BacigalupoMarco GobbiMichele Cedrone

subject

MalePediatricsHost responseBCR-ABL; Chronic myeloid leukemia; Prognosis; Tyrosine kinase inhibitors; Young adults; Adult; Age Factors; Aged; Aged 80 and over; Antineoplastic Agents; Female; Humans; Leukemia Myelogenous Chronic BCR-ABL Positive; Male; Middle Aged; Prospective Studies; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Spleen; Splenomegaly; Young Adult; Oncology; HematologyTyrosine kinase inhibitorDiseaseAntineoplastic AgentTyrosin kinase inhibitorProtein-Tyrosine Kinasehemic and lymphatic diseases80 and overAge FactorProspective StudiesYoung adultChronicBCR-ABLAged 80 and overLeukemiaIncidence (epidemiology)Chronic myeloid leukemiaAge FactorsMyeloid leukemiaHematologyMiddle AgedProtein-Tyrosine KinasesPrognosisLeukemiaOncologybcr-abl1FemaleBCR-ABL; chronic myeloid leukemia; prognosis; tyrosine kinase inhibitors; young adultsHumanAdultyoung adultsmedicine.medical_specialtyPrognosiProtein Kinase InhibitorAntineoplastic Agentschronic myeloid leukemia; bcr-abl1; Tyrosin kinase inhibitor; prognosis; young adultsNOYoung Adultchronic myeloid leukemiaLeukemia Myelogenous Chronic BCR-ABL PositivemedicineHumansBCR-ABL; Chronic myeloid leukemia; Prognosis; Tyrosine kinase inhibitors; Young adults; Adult; Age Factors; Aged; Aged 80 and over; Antineoplastic Agents; Female; Humans; Leukemia Myelogenous Chronic BCR-ABL Positive; Male; Middle Aged; Prospective Studies; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Spleen; Splenomegaly; Young AdultProtein Kinase InhibitorsAgedTyrosine kinase inhibitorsAdult patientsbusiness.industrymedicine.diseaseClinical trialBCR-ABL; Chronic myeloid leukemia; Prognosis; Tyrosine kinase inhibitors; Young adults; Adult; Age Factors; Aged; Aged 80 and over; Antineoplastic Agents; Female; Humans; Leukemia Myelogenous Chronic BCR-ABL Positive; Male; Middle Aged; Prospective Studies; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Spleen; Splenomegaly; Young Adult; Hematology; OncologyProspective StudieBCR-ABL; Chronic myeloid leukemia; Prognosis; Tyrosine kinase inhibitors; Young adults; Adult; Age Factors; Aged; Aged 80 and over; Antineoplastic Agents; Female; Humans; Leukemia Myelogenous Chronic BCR-ABL Positive; Male; Middle Aged; Prospective Studies; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Spleen; Splenomegaly; Young Adult; Medicine (all); Hematology; OncologyImmunologySplenomegalyBCR-ABL PositiveBCR-ABL chronic myeloid leukemia prognosis tyrosine kinase inhibitors young adultsprognosisbusinessSpleenYoung adultsMyelogenous

description

Abstract BACKGROUND: The incidence of chronic myeloid leukemia (CML) increases with age, but it is unclear how the characteristics of the disease vary with age. In children, where CML is very rare, it presents with more aggressive features, including huge splenomegaly, higher cell count and higher blast cell percentage. PATIENTS AND METHODS: To investigate if after childhood the disease maintains or loses these characteristics of aggressiveness, we analyzed 2784 adult patients, at least 18 years old, registered by GIMEMA CML WP over a 40-year period. RESULTS: Young adults (YAs: 18-29 years old) significantly differed from adults (30-59 years old) and elderly patients (at least 60 years old) particularly for the frequency of splenomegaly (71%, 63% and 55%, P < 0.001), and the greater spleen size (median value: 4.5, 3.0 and 1.0 cm, P < 0.001). According to the EUTOS score, that is age-independent, high-risk patients were more frequent among YAs, than among adult and elderly patients (18%, 9% and 6%, P < 0.001). In tyrosine kinase inhibitors-treated patients, the rates of complete cytogenetic and major molecular response were lower in YAs, and the probability of transformation was higher (16%, 5% and 7%, P = 0.011). CONCLUSIONS: The characteristics of CML or the host response to leukemia differ with age. The knowledge of these differences and of their causes may help to refine the treatment and to improve the outcome. CLINICAL TRIAL NUMBERS: NCT00510926, NCT00514488, NCT00769327, NCT00481052. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

yearjournalcountryeditionlanguage
2014-11-02
10.1093/annonc/mdu490http://hdl.handle.net/2158/1046242