Centre d’Investigation Clinique 802, Institut National de la Santéet de la Recherche Médicale (INSERM), University Hospital Poitiers, Poitiers, France.
J Clin Oncol. 2011 Jul 10;29(20):2827-32. doi: 10.1200/JCO.2010.32.7114. Epub 2011 Jun 13.
Imatinib is the standard of care in adults with chronic myeloid leukemia (CML) in chronic phase (CP). Only a few studies to assess efficacy in children have been performed. We report on the results of the French prospective trial (ClinicalTrials.gov identifier NCT00845221) conducted in children and adolescents with newly diagnosed CML in CP.
A total of 44 patients from age 10 months to 17 years with newly diagnosed CML in CP received daily imatinib 260 mg/m(2). Progression-free survival, responses, and tolerance were evaluated.
With a median follow-up times of 31 months (range, 11 to 64 months), the estimated progression-free survival rate at 36 months was 98% (95% CI, 85% to 100%). A complete hematologic response was achieved in 98% of the patients. The rates of complete cytogenetic response (CCyR) and major molecular response (MMR) were 61% and 31% at 12 months, respectively. During follow-up, CCyR and MMR were achieved in 36 children (77%) and 25 children (57%), respectively. Overall, 30% of the patients discontinued imatinib, mainly because of unsatisfactory response. The most common adverse events were neutropenia and musculoskeletal events.
Imatinib is effective in children with CML in CP with response rates similar to rates reported in adults. The adverse effects are acceptable, but longer follow-up studies are required to fully assess the long-term impact.
伊马替尼是慢性髓性白血病(CML)慢性期(CP)成人的标准治疗方法。仅进行了少数评估儿童疗效的研究。我们报告了在 CP 中诊断为新 CML 的儿童和青少年中进行的法国前瞻性试验(ClinicalTrials.gov 标识符 NCT00845221)的结果。
共有 44 名年龄在 10 个月至 17 岁之间的新确诊 CP 慢性髓性白血病患者接受了每日 260mg/m²伊马替尼治疗。评估了无进展生存期、反应和耐受性。
中位随访时间为 31 个月(范围 11 至 64 个月),36 个月时无进展生存率估计为 98%(95%CI,85%至 100%)。98%的患者达到完全血液学反应。12 个月时完全细胞遗传学缓解(CCyR)和主要分子缓解(MMR)的比例分别为 61%和 31%。在随访期间,36 名儿童(77%)和 25 名儿童(57%)分别达到 CCyR 和 MMR。总体而言,30%的患者停止使用伊马替尼,主要是因为反应不理想。最常见的不良事件是中性粒细胞减少和肌肉骨骼事件。
伊马替尼在 CP 中患有 CML 的儿童中有效,其反应率与成人报告的反应率相似。不良事件是可以接受的,但需要更长时间的随访研究来充分评估长期影响。