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Adolescents experienced more treatment failure than children with chronic myeloid leukemia receiving imatinib as frontline therapy: a retrospective multicenter study
To explore the differences in the clinical features, treatment responses, and outcomes among children, adolescents, and adults with chronic myeloid leukemia in the chronic phase (CML-CP) receiving imatinib as first-line therapy. Data from children (0–8 years for girls and 0–10 years for boys), adole...
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Published in: | Annals of hematology 2021-09, Vol.100 (9), p.2215-2228 |
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creator | Dou, Xuelin Zheng, Fangyuan Zhang, Liqiang Jin, Jie Zhang, Yanli Liu, Bingcheng Meng, Li Zhu, Xiaofan Lu, Zesheng Jia, Yueping Liu, Huilan Lin, Hai Zhou, Li Zhao, Xielan Yang, Wei Sun, Hui Qian, Sixuan Ma, Hongxia Du, Xin Bai, Qingxian Xu, Na Meng, Fanjun Jia, Zhilin Di, Haixia Zhang, Leping Jiang, Qian |
description | To explore the differences in the clinical features, treatment responses, and outcomes among children, adolescents, and adults with chronic myeloid leukemia in the chronic phase (CML-CP) receiving imatinib as first-line therapy. Data from children (0–8 years for girls and 0–10 years for boys), adolescents (9–19 years for girls and 11–19 years for boys), and adults (age ≥ 20 years) with newly diagnosed CML-CP receiving imatinib as first-line therapy between 2006 and 2019 were retrospectively reviewed. In total, 135 children (cohort 1), 189 adolescents (cohort 2), and 658 adults (cohort 3: age 20–39 years,
n
= 305; cohort 4: age 40–59 years,
n
= 270; and cohort 5: age 60–83 years,
n
= 83) were included in this study. When compared with children, adolescents showed a significantly higher white blood cell count (
P
= 0.033) and basophil percentage in peripheral blood (
P
= 0.002) and a significantly higher prevalence of splenomegaly (
P
= 0.004). Both children and adolescents presented with more aggressive clinical features than adults. During median follow-ups of 28 months (range, 3–161 months) in children, 33 months (range, 3–152 months) in adolescents, and 48 months (range, 3–157 months) in adults, multivariate analysis showed that children and adolescents had higher probabilities of achieving complete cytogenetic response, major molecular response, and molecular response
4.5
. Notably, compared with not only adults (cohort 3 vs. cohort 1: HR = 2.03 [1.03, 3.98],
P
= 0.040; cohort 4 vs. cohort 1: HR = 2.15 [1.07, 4.33],
P
= 0.033; cohort 5 vs. cohort 1: HR = 4.22 [1.94, 9.15],
P
|
doi_str_mv | 10.1007/s00277-021-04544-6 |
format | article |
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n
= 305; cohort 4: age 40–59 years,
n
= 270; and cohort 5: age 60–83 years,
n
= 83) were included in this study. When compared with children, adolescents showed a significantly higher white blood cell count (
P
= 0.033) and basophil percentage in peripheral blood (
P
= 0.002) and a significantly higher prevalence of splenomegaly (
P
= 0.004). Both children and adolescents presented with more aggressive clinical features than adults. During median follow-ups of 28 months (range, 3–161 months) in children, 33 months (range, 3–152 months) in adolescents, and 48 months (range, 3–157 months) in adults, multivariate analysis showed that children and adolescents had higher probabilities of achieving complete cytogenetic response, major molecular response, and molecular response
4.5
. Notably, compared with not only adults (cohort 3 vs. cohort 1: HR = 2.03 [1.03, 3.98],
P
= 0.040; cohort 4 vs. cohort 1: HR = 2.15 [1.07, 4.33],
P
= 0.033; cohort 5 vs. cohort 1: HR = 4.22 [1.94, 9.15],
P
< 0.001) but also adolescents (cohort 2 vs. cohort 1: HR = 2.36 [1.18, 4.72], P = 0.015), children had significantly longer failure-free survival. Age was not associated with progression-free survival or overall survival. Although they exhibited more aggressive clinical features at diagnosis, both children and adolescents achieved superior treatment responses than adults. Adolescents showed even more adverse features and a poor FFS than children.</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-021-04544-6</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age ; Hematology ; Inhibitor drugs ; Leukemia ; Medicine ; Medicine & Public Health ; Oncology ; Original Article ; Targeted cancer therapy ; Teenagers</subject><ispartof>Annals of hematology, 2021-09, Vol.100 (9), p.2215-2228</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-b9ae391fd41d5947c093c3aa3624d0aa5c89ffa71fe97c3c240781b803302acc3</citedby><cites>FETCH-LOGICAL-c352t-b9ae391fd41d5947c093c3aa3624d0aa5c89ffa71fe97c3c240781b803302acc3</cites><orcidid>0000-0001-7131-0522</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Dou, Xuelin</creatorcontrib><creatorcontrib>Zheng, Fangyuan</creatorcontrib><creatorcontrib>Zhang, Liqiang</creatorcontrib><creatorcontrib>Jin, Jie</creatorcontrib><creatorcontrib>Zhang, Yanli</creatorcontrib><creatorcontrib>Liu, Bingcheng</creatorcontrib><creatorcontrib>Meng, Li</creatorcontrib><creatorcontrib>Zhu, Xiaofan</creatorcontrib><creatorcontrib>Lu, Zesheng</creatorcontrib><creatorcontrib>Jia, Yueping</creatorcontrib><creatorcontrib>Liu, Huilan</creatorcontrib><creatorcontrib>Lin, Hai</creatorcontrib><creatorcontrib>Zhou, Li</creatorcontrib><creatorcontrib>Zhao, Xielan</creatorcontrib><creatorcontrib>Yang, Wei</creatorcontrib><creatorcontrib>Sun, Hui</creatorcontrib><creatorcontrib>Qian, Sixuan</creatorcontrib><creatorcontrib>Ma, Hongxia</creatorcontrib><creatorcontrib>Du, Xin</creatorcontrib><creatorcontrib>Bai, Qingxian</creatorcontrib><creatorcontrib>Xu, Na</creatorcontrib><creatorcontrib>Meng, Fanjun</creatorcontrib><creatorcontrib>Jia, Zhilin</creatorcontrib><creatorcontrib>Di, Haixia</creatorcontrib><creatorcontrib>Zhang, Leping</creatorcontrib><creatorcontrib>Jiang, Qian</creatorcontrib><title>Adolescents experienced more treatment failure than children with chronic myeloid leukemia receiving imatinib as frontline therapy: a retrospective multicenter study</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><description>To explore the differences in the clinical features, treatment responses, and outcomes among children, adolescents, and adults with chronic myeloid leukemia in the chronic phase (CML-CP) receiving imatinib as first-line therapy. Data from children (0–8 years for girls and 0–10 years for boys), adolescents (9–19 years for girls and 11–19 years for boys), and adults (age ≥ 20 years) with newly diagnosed CML-CP receiving imatinib as first-line therapy between 2006 and 2019 were retrospectively reviewed. In total, 135 children (cohort 1), 189 adolescents (cohort 2), and 658 adults (cohort 3: age 20–39 years,
n
= 305; cohort 4: age 40–59 years,
n
= 270; and cohort 5: age 60–83 years,
n
= 83) were included in this study. When compared with children, adolescents showed a significantly higher white blood cell count (
P
= 0.033) and basophil percentage in peripheral blood (
P
= 0.002) and a significantly higher prevalence of splenomegaly (
P
= 0.004). Both children and adolescents presented with more aggressive clinical features than adults. During median follow-ups of 28 months (range, 3–161 months) in children, 33 months (range, 3–152 months) in adolescents, and 48 months (range, 3–157 months) in adults, multivariate analysis showed that children and adolescents had higher probabilities of achieving complete cytogenetic response, major molecular response, and molecular response
4.5
. Notably, compared with not only adults (cohort 3 vs. cohort 1: HR = 2.03 [1.03, 3.98],
P
= 0.040; cohort 4 vs. cohort 1: HR = 2.15 [1.07, 4.33],
P
= 0.033; cohort 5 vs. cohort 1: HR = 4.22 [1.94, 9.15],
P
< 0.001) but also adolescents (cohort 2 vs. cohort 1: HR = 2.36 [1.18, 4.72], P = 0.015), children had significantly longer failure-free survival. Age was not associated with progression-free survival or overall survival. Although they exhibited more aggressive clinical features at diagnosis, both children and adolescents achieved superior treatment responses than adults. Adolescents showed even more adverse features and a poor FFS than children.</description><subject>Age</subject><subject>Hematology</subject><subject>Inhibitor drugs</subject><subject>Leukemia</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Targeted cancer 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B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7131-0522</orcidid></search><sort><creationdate>20210901</creationdate><title>Adolescents experienced more treatment failure than children with chronic myeloid leukemia receiving imatinib as frontline therapy: a retrospective multicenter study</title><author>Dou, Xuelin ; Zheng, Fangyuan ; Zhang, Liqiang ; Jin, Jie ; Zhang, Yanli ; Liu, Bingcheng ; Meng, Li ; Zhu, Xiaofan ; Lu, Zesheng ; Jia, Yueping ; Liu, Huilan ; Lin, Hai ; Zhou, Li ; Zhao, Xielan ; Yang, Wei ; Sun, Hui ; Qian, Sixuan ; Ma, Hongxia ; Du, Xin ; Bai, Qingxian ; Xu, Na ; Meng, Fanjun ; Jia, Zhilin ; Di, Haixia ; Zhang, Leping ; Jiang, Qian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-b9ae391fd41d5947c093c3aa3624d0aa5c89ffa71fe97c3c240781b803302acc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Hematology</topic><topic>Inhibitor drugs</topic><topic>Leukemia</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Targeted cancer therapy</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dou, Xuelin</creatorcontrib><creatorcontrib>Zheng, Fangyuan</creatorcontrib><creatorcontrib>Zhang, Liqiang</creatorcontrib><creatorcontrib>Jin, 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Qian</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete 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Wei</au><au>Sun, Hui</au><au>Qian, Sixuan</au><au>Ma, Hongxia</au><au>Du, Xin</au><au>Bai, Qingxian</au><au>Xu, Na</au><au>Meng, Fanjun</au><au>Jia, Zhilin</au><au>Di, Haixia</au><au>Zhang, Leping</au><au>Jiang, Qian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adolescents experienced more treatment failure than children with chronic myeloid leukemia receiving imatinib as frontline therapy: a retrospective multicenter study</atitle><jtitle>Annals of hematology</jtitle><stitle>Ann Hematol</stitle><date>2021-09-01</date><risdate>2021</risdate><volume>100</volume><issue>9</issue><spage>2215</spage><epage>2228</epage><pages>2215-2228</pages><issn>0939-5555</issn><eissn>1432-0584</eissn><abstract>To explore the differences in the clinical features, treatment responses, and outcomes among children, adolescents, and adults with chronic myeloid leukemia in the chronic phase (CML-CP) receiving imatinib as first-line therapy. Data from children (0–8 years for girls and 0–10 years for boys), adolescents (9–19 years for girls and 11–19 years for boys), and adults (age ≥ 20 years) with newly diagnosed CML-CP receiving imatinib as first-line therapy between 2006 and 2019 were retrospectively reviewed. In total, 135 children (cohort 1), 189 adolescents (cohort 2), and 658 adults (cohort 3: age 20–39 years,
n
= 305; cohort 4: age 40–59 years,
n
= 270; and cohort 5: age 60–83 years,
n
= 83) were included in this study. When compared with children, adolescents showed a significantly higher white blood cell count (
P
= 0.033) and basophil percentage in peripheral blood (
P
= 0.002) and a significantly higher prevalence of splenomegaly (
P
= 0.004). Both children and adolescents presented with more aggressive clinical features than adults. During median follow-ups of 28 months (range, 3–161 months) in children, 33 months (range, 3–152 months) in adolescents, and 48 months (range, 3–157 months) in adults, multivariate analysis showed that children and adolescents had higher probabilities of achieving complete cytogenetic response, major molecular response, and molecular response
4.5
. Notably, compared with not only adults (cohort 3 vs. cohort 1: HR = 2.03 [1.03, 3.98],
P
= 0.040; cohort 4 vs. cohort 1: HR = 2.15 [1.07, 4.33],
P
= 0.033; cohort 5 vs. cohort 1: HR = 4.22 [1.94, 9.15],
P
< 0.001) but also adolescents (cohort 2 vs. cohort 1: HR = 2.36 [1.18, 4.72], P = 0.015), children had significantly longer failure-free survival. Age was not associated with progression-free survival or overall survival. Although they exhibited more aggressive clinical features at diagnosis, both children and adolescents achieved superior treatment responses than adults. Adolescents showed even more adverse features and a poor FFS than children.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00277-021-04544-6</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0001-7131-0522</orcidid></addata></record> |
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subjects | Age Hematology Inhibitor drugs Leukemia Medicine Medicine & Public Health Oncology Original Article Targeted cancer therapy Teenagers |
title | Adolescents experienced more treatment failure than children with chronic myeloid leukemia receiving imatinib as frontline therapy: a retrospective multicenter study |
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