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Cancer. 2005 Jun 21; [Epub ahead of print] Related Articles, Links


Significance of myelofibrosis in early chronic-phase, chronic myelogenous
leukemia on imatinib mesylate therapy.

Kantarjian HM, Bueso-Ramos CE, Talpaz M, O'brien S, Giles F, Faderl S,
Wierda W, Rios MB, Shan J, Cortes J.

Department of Leukemia, The University of Texas M. D. Anderson Cancer
Center, Houston, Texas.

BACKGROUND: Myelofibrosis is associated historically with a poor prognosis
in patients with chronic myelogenous leukemia (CML). Its significance in the
recent era of effective therapy with imatinib mesylate is unknown. METHODS:
The current study evaluated the significance of the degree of pretreatment
myelofibrosis on response and survival with imatinib therapy in patients
with newly diagnosed CML. The study group comprised 198 patients with newly
diagnosed Philadelphia chromosome-positive, chronic-phase CML treated with
imatinib mesylate therapy. They were analyzed for the prognostic
significance of bone marrow reticulin fibrosis. RESULTS: Severe reticulin
(Grade 3-4) fibrosis was observed in 75 patients (38%): Grade 3 in 46 (23%)
patients and Grade 4 in 29 (15%) patients. There was a trend towards a lower
incidence of a complete cytogenetic response in patients with Grade 4
reticulin fibrosis (76% vs. 89%; P = 0.07), and a significantly worse
survival (estimated 3-year survival rate of 87% vs. 97%; P = 0.04).
CONCLUSIONS: Although the prognostic significance of severe reticulin
fibrosis in patients with newly diagnosed CML receiving imatinib therapy was
better, 15% of patients with Grade 4 reticulin fibrosis still had a worse
outcome. Cancer 2005. (c) 2005 American Cancer Society.

PMID: 15971197 [PubMed - as supplied by publisher]

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