First-line imatinib mesylate in patients with newly diagnosed accelerated phase-chronic myeloid leukemia

Leukemia, 04/30/2012

Rea D et al. – Frontline imatinib allows favorable outcomes in HEM–accelerated–phase (AP) and ACA–AP patients but appears insufficient for patients with HEM–AP+ACA. Broader–target and/or more potent BCR–ABL tyrosine kinase inhibitors alone or in combination may be considered in this setting.


  • The authors evaluated the benefit of imatinib in 42 newly diagnosed AP-CML patients.


  • In all, 16 patients had hematological acceleration without chromosomal abnormalities in addition to the Philadelphia chromosome (ACAs; HEM-AP), 16 solely had ACAs (ACA-AP) and 10 had hematological acceleration plus ACAs (HEM-AP+ACA).
  • Major cytogenetic responses were achieved in 93.7% of HEM-AP patients, 75% of patients with ACA-AP (P=NS) and 40% of patients with HEM-AP+ACA (P=0.0053).
  • The 24-month failure-free survival rate was 87.5% in HEM-AP patients, 43.8% in ACA-AP patients and 15% in HEM-AP+ACA patients (P=0.022).
  • The 24-month estimate of progression-free survival was 100% in HEM-AP patients, 92.8% in ACA-AP patients and 58.3% in HEM-AP+ACA patients (P=0.0052).

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