Frontiers in Oncology (Aug 2021)
Prognostic Factors for Overall Survival In Chronic Myeloid Leukemia Patients: A Multicentric Cohort Study by the Italian CML GIMEMA Network
- Giorgina Specchia,
- Patrizia Pregno,
- Massimo Breccia,
- Fausto Castagnetti,
- Chiara Monagheddu,
- Massimiliano Bonifacio,
- Mario Tiribelli,
- Fabio Stagno,
- Giovanni Caocci,
- Bruno Martino,
- Luigiana Luciano,
- Michele Pizzuti,
- Antonella Gozzini,
- Anna Rita Scortechini,
- Francesco Albano,
- Micaela Bergamaschi,
- Isabella Capodanno,
- Andrea Patriarca,
- Carmen Fava,
- Giovanna Rege-Cambrin,
- Federica Sorà,
- Sara Galimberti,
- Monica Bocchia,
- Gianni Binotto,
- Giovanni Reddiconto,
- Paolo DiTonno,
- Alessandro Maggi,
- Grazia Sanpaolo,
- Maria Stella De Candia,
- Valentina Giai,
- Elisabetta Abruzzese,
- Maria Cristina Miggiano,
- Gaetano La Barba,
- Giuseppe Pietrantuono,
- Anna Guella,
- Luciano Levato,
- Olga Mulas,
- Fabio Saccona,
- Gianantonio Rosti,
- Pellegrino Musto,
- Francesco Di Raimondo,
- Fabrizio Pane,
- Michele Baccarani,
- Giuseppe Saglio,
- Giovannino Ciccone
Affiliations
- Giorgina Specchia
- Former Full Professor of Hematology- University of Bari Aldo Moro” Bari GIMEMA WP CML, Bari, Italy
- Patrizia Pregno
- Haematology Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
- Massimo Breccia
- Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Roma, Italy
- Fausto Castagnetti
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
- Chiara Monagheddu
- Clinical Epidemiology Unit and CPO Piemonte, Città della Salute e della Scienza, Torino, Italy
- Massimiliano Bonifacio
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
- Mario Tiribelli
- Division of Hematology and BMT, Department of Medical Area, University of Udine, Udine, Italy
- Fabio Stagno
- Division of Hematology and Bone Marrow Transplant, Azienda Ospedaliera-Universitaria (AOU) Policlinico-V. Emanuele, Catania, Italy
- Giovanni Caocci
- Department of Medical Sciences and Public Health, Businco Hospital, University of Cagliari, Cagliari, Italy
- Bruno Martino
- 0Haematology Unit, Azienda Ospedaliera “Bianchi-Melacrino-Morelli”, Reggio Calabria, Italy
- Luigiana Luciano
- 1Haematology Unit “Federico II”, University of Naples, Naples, Italy
- Michele Pizzuti
- 2Department of Hematology, “San Carlo” Regional Hospital, Potenza, Italy
- Antonella Gozzini
- 3Haematology Unit, AOU Careggi, University of Florence, Florence, Italy
- Anna Rita Scortechini
- 4Division of Hematology, Department of Molecular and Clinical Sciences, Polytechnic University of Marche, Ancona, Italy
- Francesco Albano
- 5Department of Emergency and Transplantation, Hematology Section, University of Bari Medical School, Bari, Italy
- Micaela Bergamaschi
- 6Clinical Hematology, Policlinico San Martino, Genua, Italy
- Isabella Capodanno
- 7Department of Hematology, Azienda UNITà SANITARIA LOCALE (USL)-IRCCS di Reggio Emilia, Viale Risorgimento, Reggio Emilia, Italy
- Andrea Patriarca
- 8Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
- Carmen Fava
- 9Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
- Giovanna Rege-Cambrin
- 0Orbassano Hospital, Turin University, Turin, Italy
- Federica Sorà
- 1Institute of Hematology, Università Cattolica Sacro Cuore, Rome, Italy
- Sara Galimberti
- 2Department of Clinical and Experimental Medicine, Unità Operativa (UO) Haematology, AOU Pisana, Pisa, Italy
- Monica Bocchia
- 3Haematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
- Gianni Binotto
- 4Padova Hematology and Clinical Immunology, Padua, Italy
- Giovanni Reddiconto
- 5Department of Ematologia, Lecce Ematologia Ospedale Vito Fazzi, Lecce, Italy
- Paolo DiTonno
- 6Haematology Unit, National Cancer Center, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
- Alessandro Maggi
- 7Division of Hematology, Hospital “S.G. Moscati”, Taranto, Italy
- Grazia Sanpaolo
- 8Department of Hematology and Stem Cell Transplantation Unit, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
- Maria Stella De Candia
- 9Hematology, Hospital A. Perrino, Brindisi, Italy
- Valentina Giai
- Haematology Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
- Elisabetta Abruzzese
- 0Hemoglobinopathies Unit, Hematology Department, S. Eugenio Hospital (ASL Roma 2), Rome, Italy
- Maria Cristina Miggiano
- 1Hematology Department, San Bortolo Hospital, Vicenza, Italy
- Gaetano La Barba
- 2Department of Hematology, “Spirito Santo” Hospital, Pescara, Italy
- Giuseppe Pietrantuono
- 3Hematology Oncology, IRCCS Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
- Anna Guella
- 4Hematology Unit, Santa Chiara Hospital, Trento, Italy
- Luciano Levato
- 5Haematology Unit, A. Pugliese Hospital, Azienda Ospedaliera Pugliese Ciaccio, Catanzaro, Italy
- Olga Mulas
- Department of Medical Sciences and Public Health, Businco Hospital, University of Cagliari, Cagliari, Italy
- Fabio Saccona
- Clinical Epidemiology Unit and CPO Piemonte, Città della Salute e della Scienza, Torino, Italy
- Gianantonio Rosti
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
- Pellegrino Musto
- 5Department of Emergency and Transplantation, Hematology Section, University of Bari Medical School, Bari, Italy
- Francesco Di Raimondo
- Division of Hematology and Bone Marrow Transplant, Azienda Ospedaliera-Universitaria (AOU) Policlinico-V. Emanuele, Catania, Italy
- Fabrizio Pane
- 1Haematology Unit “Federico II”, University of Naples, Naples, Italy
- Michele Baccarani
- Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
- Giuseppe Saglio
- 9Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
- Giovannino Ciccone
- Clinical Epidemiology Unit and CPO Piemonte, Città della Salute e della Scienza, Torino, Italy
- DOI
- https://doi.org/10.3389/fonc.2021.739171
- Journal volume & issue
-
Vol. 11
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.
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