Ann Med: Outcomes in adolescents and young adults with chronic phase chronic myeloid leukemia treated with tyrosine kinase inhibitors

The prognosis of chronic myeloid leukemia (CML) has improved significantly since the introduction of tyrosine kinase inhibitor (TKI) therapy
.
Few studies have reported the efficacy of tyrosine kinase inhibitors (TKIs), including the second-generation TKIs nilotinib and dasatinib, in adolescents and young adults (AYA) with chronic phase chronic myeloid leukemia (CML-CP) Therefore, a research team retrospectively analyzed the clinical characteristics and outcomes of AYA patients with CML-CP treated with TKIs, and further evaluated the outcomes of AYA patients treated with nilotinib and dasatinib
.

The prognosis of chronic myeloid leukemia (CML) has improved significantly since the introduction of tyrosine kinase inhibitor (TKI) therapy
.
Few studies have reported the efficacy of tyrosine kinase inhibitors (TKIs), including the second-generation TKIs nilotinib and dasatinib, in adolescents and young adults (AYA) with chronic phase chronic myeloid leukemia (CML-CP) Therefore, a research team retrospectively analyzed the clinical characteristics and outcomes of AYA patients with CML-CP treated with TKIs, and further evaluated the outcomes of AYA patients treated with nilotinib and dasatinib
.

The researchers retrospectively analyzed the clinical characteristics, treatment response, and long-term outcomes of 42 AYA patients and older patients
.
Initial treatments for AYA patients between 2001 and 2016 included imatinib (n = 24), dasatinib (n = 13), and nilotinib (n = 5)
.

The researchers retrospectively analyzed the clinical characteristics, treatment response, and long-term outcomes of 42 AYA patients and older patients
.
Initial treatments for AYA patients between 2001 and 2016 included imatinib (n = 24), dasatinib (n = 13), and nilotinib (n = 5)
.
42

Figure 1: Molecular responses to TKIs according to age group
.
p: level of significance between AYA and the elderly group
.
MMR: major molecular response; DMR: deep molecular response; TKI: tyrosine kinase inhibitor
.

Figure 1: Molecular responses to TKIs according to age group
.
p: level of significance between AYA and the elderly group
.
MMR: major molecular response; DMR: deep molecular response; TKI: tyrosine kinase inhibitor
.

Figure 2: Responses to TKIs by age group
.
(A) Cumulative incidence of MMR
.
(B) Cumulative incidence of DMR
.
p indicates the significance level between AYA and the elderly group
.
MMR: major molecular response; DMR: deep molecular response; TKI: tyrosine kinase inhibitor

Figure 2: Responses to TKIs by age group
.
(A) Cumulative incidence of MMR
.
(B) Cumulative incidence of DMR
.
p indicates the significance level between AYA and the elderly group
.
MMR: major molecular response; DMR: deep molecular response; TKI: tyrosine kinase inhibitor

In AYA patients, peripheral blood (PB) white blood cell counts and percentage of blasts were significantly elevated at diagnosis, hemoglobin levels were lower, and spleens were larger

.

Figure 3: Cumulative incidence of conversion to AP or BP by age group

Figure 3: Cumulative incidence of conversion to AP or BP by age group

Figure 4: Long-term outcomes of patients treated with TKIs by age group

Figure 4: Long-term outcomes of patients treated with TKIs by age group

Figure 5: Molecular responses to each TKI, grouped by age

Figure 5: Molecular responses to each TKI, grouped by age

In conclusion, AYA patients had a higher tumor burden at the time of diagnosis of CML-CP, but their prognosis was not poor compared with older patients treated with TKIs

Original source:

Original source:

Nishiyama-Fujita Y, Nakazato T, Iriyama N, Tokuhira M, Ishikawa M, Sato E, Takaku T, Sugimoto K, Fujita H, Fujioka I, Tsuchiya S, Kimura Y, Iwanaga E, Komatsu N, Asou N, Kizaki M, Hatta Y, Kawaguchi T.

Nishiyama-Fujita Y, Nakazato T, Iriyama N, Tokuhira M, Ishikawa M, Sato E, Takaku T, Sugimoto K, Fujita H, Fujioka I, Tsuchiya S, Kimura Y, Iwanaga E, Komatsu N, Asou N, Kizaki M, Hatta Y, Kawaguchi T.
Outcomes of adolescents and young adults with chronic-phase chronic myeloid leukaemia treated with tyrosine kinase inhibitors.
Ann Med.
2022 Dec;54(1):1244-1254.
doi: 10.
1080/07853890.
2022.
2069280.
PMID: 35486442.
Nishiyama-Fujita Y, Nakazato T, Iriyama N, Tokuhira M, Ishikawa M, Sato E, Takaku T, Sugimoto K, Fujita H, Fujioka I, Tsuchiya S, Kimura Y, Iwanaga E, Komatsu N, Asou N, Kizaki M, Hatta Y, Kawaguchi T.
Outcomes of adolescents and young adults with chronic-phase chronic myeloid leukaemia treated with tyrosine kinase inhibitors.
Ann Med.
2022 Dec;54(1):1244-1254.
doi: 10.
1080/07853890.
2022.
2069280.
PMID: 35486442.


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