Abstract

6602 Background: Management of CML has been transformed by targeted therapies like TKI. It has been described in clinical trial that an increased OS of pts giving hope but also opportunity to observe late effects of TKI treatment (Tt) as an increased occur of K. Our objective was to evaluate in a real life cohort of CML pts the impact of TKI on OS and to report new diagnosed K occurring during Tt. Methods: We conducted a retrospective, observational study from the CML database including all consecutive pts with CML into a French regional network. Included criteria were cytogenetic (Cg) or molecular (MB) proved CML. Clinical and biological data, Tt response and outcome including other K were collected and statistically analyzed. Results: We identified 176 pts with CML diagnosed since 1978, SR 1.2, median age 59 (22-84), regional incidence 1.08 vs 1 in France. At diagnosis, pts were in CML-CP 92% (n = 162), CML-AP 5.7% (n = 10), CML-BC 0.6% (n = 1), missing (ND) 1.7% (n = 3). Sokal < 0.8 for 61% (n = 108), 0.8-1.2 for 24% (n = 42), > 1.2 for 11% (n = 19), ND for 4% (n = 7). t(9,22) or Bcr-Abl expressing in MB was 100% with another Cg abnormality in 8%.Tt was non TKI 28% (n = 49), TKIs for 72% (127/176) with 54% (n = 68) in first line, 20% (n = 26) second line and 26% (n = 33) third line or more. In TKI cohort: RCC at 6, 12 and 24 months (m) were respectively 57%, 66%, 83% and MMR/CMR at 6, 12 and 24 m were 14%, 23%, 37%. K occurred during TKI in 12 pts (9.6%), SR 1.4, median age 76 (59-86), median follow up of CML 40.5 m (28-137), median duration TKI: 37 m (26-77). Histologic type of K : 3 prostate, 2 colon, 1 breast, 1 pancreas, 1 lung, 1 parotid, 1 melanoma, 1 renal and 1 bladder. 92% (n = 11) were treated for K, 75% (n = 9) still alive with TKI. Median OS of pts never receiving TKI: 4 y, receiving TKI in second line or more: 18 y, TKI in first line: not reached (p < 0.0001). Conclusions: In real life,TKI Tt with monitored response according to the guidelineshad improved median OS of pts non included in clinical trial, even if they already received several lines of Tt. The occurence of K diagnosed during TKI in our study was 9.6% vs. 4.07% reported in another study (Verma ASH 2008). The older median age in our series (76 y vs. 67 y) may explain the higher rate of K. No significant financial relationships to disclose.

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