GIMEMA Network Analysis Identifies Prognostic Factors for Overall Survival in CML

In an observational prospective study by the CML Italian network, researchers analyzed the role of baseline patient characteristics and first-line treatments on overall survival and chronic myeloid leukemia (CML)–related mortality. The findings were published in Frontiers in Oncology.

The study included 1,206 patients with newly diagnosed CML. A total of 608 were treated with imatinib and 598 with a second-generation tyrosine kinase inhibitor (TKI). According to the report, imatinib-treated patients were much older (median age = 69 years) than the second-generation TKI group (median age = 52 years). The imatinib-treated group also had more comorbidities.

Among the entire cohort, the estimated four-year overall survival was 89%. A total of 73 patients (6.1%) died during follow-up, which included 17 (2.8%) in the second-generation TKI group and 56 (9.2%) in the imatinib cohort. This translated to an adjusted hazard ratio (HR) of 0.50 in favor of second-generation TKI, but no differences were detected for CML-related mortality (10 patients [1.7%] vs. 11 patients [1.8%]; HR = 1.61).

Analysis of survival with patient factors found that the EUTOS long-term survival (ELTS) score was associated with CML mortality (high risk vs. low, HR = 9.67; P < 0.001). The following factors were associated with an increased risk of CML-unrelated mortality:

  • age (HR = 1.03; P = 0.064)
  • Charlson Comorbidity Index (4-5 vs. 2, HR = 5.22; P < 0.001)
  • ELTS score (high risk vs. low, HR = 3.11; P = 0.002)
  • second-generation TKI vs. IMA (HR = 0.26; P= 0.004)

The authors noted that the ELTS score showed a better discriminant ability than the Sokal score in all comparisons.