TY - JOUR
T1 - Imatinib and polypharmacy in very old patients with chronic myeloid leukemia: Effects on response rate, toxicity and outcome
AU - Sora', Federica
AU - Sica, Simona
AU - Mansueto, Giovanna Rosaria
AU - Storti, Sergio
AU - Iurlo, Alessandra
AU - Nobili, Alessandro
AU - Latagliata, Roberto
AU - Bucelli, Cristina
AU - Castagnetti, Fausto
AU - Breccia, Massimo
AU - Abruzzese, Elisabetta
AU - Cattaneo, Daniele
AU - Fava, Carmen
AU - Ferrero, Dario
AU - Gozzini, Antonella
AU - Bonifacio, Massimiliano
AU - Tiribelli, Mario
AU - Pregno, Patrizia
AU - Stagno, Fabio
AU - Vigneri, Paolo
AU - Annunziata, Mario
AU - Cavazzini, Francesco
AU - Binotto, Gianni
AU - Mansueto, Giovanna
AU - Russo, Sabina
AU - Falzetti, Franca
AU - Montefusco, Enrico
AU - Gugliotta, Gabriele
AU - D'Addosio, Ada M.
AU - Scaffidi, Luigi
AU - Cortesi, Laura
AU - Cedrone, Michele
AU - Rossi, Antonella Russo
AU - Avanzini, Paolo
AU - Mauro, Endri
AU - Spadea, Antonio
AU - Celesti, Francesca
AU - Giglio, Gianfranco
AU - Isidori, Alessandro
AU - Crugnola, Monica
AU - Calistri, Elisabetta
AU - Rege-Cambrin, Giovanna
AU - Luciano, Luigiana
AU - Galimberti, Sara
AU - Orlandi, Ester M.
AU - Bocchia, Monica
AU - Tettamanti, Mauro
AU - Alimena, Giuliana
AU - Saglio, Giuseppe
AU - Rosti, Gianantonio
AU - Mannucci, Pier Mannuccio
AU - Cortelezzi, Agostino
PY - 2016
Y1 - 2016
N2 - Background: About 40% of all patients with chronic myeloid leukemia are currently old or very old. They are effectively treated with imatinib, even though underrepresented in clinical studies. Furthermore, as it happens in the general population, they often receive multiple drugs for associated chronic illnesses. Aim of this study was to assess whether or not in imatinib-treated patients aged > 75 years the exposure to polypharmacy (5 drugs or more) had an impact on cytogenetic and molecular response rates, event-free and overall survival, as well as on hematological or extra-hematological toxicity. Methods: 296 patients at 35 Italian hematological institutions were evaluated. Results: Polypharmacy was reported in 107 patients (36.1%), and drugs more frequently used were antiplatelets, diuretics, proton pump inhibitors, ACE-inhibitors, beta-blockers, calcium channel blockers, angiotensin II receptors blockers, statins, oral hypoglycemic drugs and alpha blockers. Complete cytogenetic response was obtained in 174 patients (58.8%), 78 (26.4%) within 6 month, 63 (21.3%) between 7 and 12 months. Major molecular response was obtained in 153 patients (51.7%), 64 (21.6%) within the 12 month. One hundred and twenty-eight cases (43.2%) of hematological toxicity were recorded, together with 167 cases (56.4%) of extra-hematological toxicity. Comparing patients exposed to polypharmacy to those without, no difference was observed pertaining to the dosage of imatinib, cytogenetic and molecular responses and hematological and extra-hematological toxicity. Conclusion: Notwithstanding the several interactions reported in the literature between imatinib and some of the medications considered herewith, this fact does not seem to have a clinical impact on response rate and outcome.
AB - Background: About 40% of all patients with chronic myeloid leukemia are currently old or very old. They are effectively treated with imatinib, even though underrepresented in clinical studies. Furthermore, as it happens in the general population, they often receive multiple drugs for associated chronic illnesses. Aim of this study was to assess whether or not in imatinib-treated patients aged > 75 years the exposure to polypharmacy (5 drugs or more) had an impact on cytogenetic and molecular response rates, event-free and overall survival, as well as on hematological or extra-hematological toxicity. Methods: 296 patients at 35 Italian hematological institutions were evaluated. Results: Polypharmacy was reported in 107 patients (36.1%), and drugs more frequently used were antiplatelets, diuretics, proton pump inhibitors, ACE-inhibitors, beta-blockers, calcium channel blockers, angiotensin II receptors blockers, statins, oral hypoglycemic drugs and alpha blockers. Complete cytogenetic response was obtained in 174 patients (58.8%), 78 (26.4%) within 6 month, 63 (21.3%) between 7 and 12 months. Major molecular response was obtained in 153 patients (51.7%), 64 (21.6%) within the 12 month. One hundred and twenty-eight cases (43.2%) of hematological toxicity were recorded, together with 167 cases (56.4%) of extra-hematological toxicity. Comparing patients exposed to polypharmacy to those without, no difference was observed pertaining to the dosage of imatinib, cytogenetic and molecular responses and hematological and extra-hematological toxicity. Conclusion: Notwithstanding the several interactions reported in the literature between imatinib and some of the medications considered herewith, this fact does not seem to have a clinical impact on response rate and outcome.
KW - Chronic myeloid leukemia
KW - Comorbidities
KW - Imatinib
KW - Old patients
KW - Oncology
KW - Polypharmacy
KW - Chronic myeloid leukemia
KW - Comorbidities
KW - Imatinib
KW - Old patients
KW - Oncology
KW - Polypharmacy
UR - http://hdl.handle.net/10807/92915
UR - http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=download&path%5b%5d=11657&path%5b%5d=36905
U2 - 10.18632/oncotarget.11657
DO - 10.18632/oncotarget.11657
M3 - Article
VL - 7
SP - 80083
EP - 80090
JO - Oncotarget
JF - Oncotarget
SN - 1949-2553
ER -