Advances in Clinical and Experimental Medicine
2018, vol. 27, nr 1, January, p. 91–98
Publication type: original article
Imatinib in the treatment of chronic myeloid leukemia in children and adolescents is effective and well tolerated: Report of the Polish Pediatric Study Group for the Treatment of Leukemias and Lymphomas
1 Department and Clinic of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, Poland
2 Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Poland
3 Department of Pediatrics, Hematology and Oncology, Dr Edward Hanke Chorzów Center of Pediatrics and Oncology, Poland
4 Department and Clinic of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Poland
5 Silesian Children's Health Center, Department of Oncology, Hematology and Pediatric Chemotherapy, Medical University of Silesia in Katowice, Poland
6 Department of Oncology and Hematology, Polish-American Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
7 Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Poland
8 Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Poland
9 Department of Pediatrics, Pediatric Hematology and Oncology, Pomeranian Medical University in Szczecin, Poland
10 Department and Clinic of Pediatrics, Hematology and Oncology, Medical University of Warsaw, Poland
11 Department of Oncology, Hematology and Pediatric Transplantatology, Poznan University of Medical Sciences, Poland
12 Department of Pediatrics, Hematology and Oncology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland
13 Department of Hematooncology, Wladyslaw Buszkowski Provincial Specialist Children's Hospital in Kielce, Poland
14 Department and Clinic of Pediatric Hematology and Oncology, Prof. Stanisław Popowski Provincial Specialist Childrens’ Hospital in Olsztyn, Poland
Background. Chronic myeloid leukemia (CML) constitutes only 2–3% of all leukemias in pediatric patients. Philapelphia chromosome and BCR-ABL fusion are genetic hallmarks of CML, and their presence is crucial for targeted molecular therapy with tyrosine kinase inhibitors (TKIs), which replaced hematopoietic stem cell transplantation (HSCT) as a standard first-line therapy. The disease in pediatric population is rare, and despite molecular and clinical similarities to CML in adults, different approach is needed, due to the long lifetime expectancy and distinct developmental characteristics of affected children.
Objectives. The objective of this study is to evaluate treatment with imatinib in Polish pediatric patients with CML.
Material and Methods. We analyzed the results of treatment with imatinib in 57 pediatric patients (June 2006 – January 2016) from 14 Polish pediatric hematology and oncology centers.
Results. In the study group, 40 patients continued imatinib (median follow-up: 23.4 months), while in 17 the treatment was terminated (median follow-up: 15.1 months) due to therapy failure. In the latter group, 13 patients underwent HSCT, while 4 switched to second-generation TKIs. The 5-year overall survival rate (OS) in the study group was 96%, and the 5-year event-free survival (EFS) was 81%.
Conclusion. Our results confirm that the introduction of TKI therapy has revolutionized the treatment of CML in the pediatric population by replacing the previous method of treatment with HSCT and allowing a high percentage of OS and EFS.
children, imatinib, adolescents, chronic myeloid leukemia
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