CML-292 Chronic Myeloid Leukemia Reduces Survival in Elderly Patients (Age ≥ 75 Years Old): An International Multicenter Retrospective Study

• Published in: Clinical lymphoma, myeloma and leukemia Vol. 23; p. S335
• Main Authors: Halperin, Erez, Rozental, Alon, Leibovitch, Chiya, Barzilai, Merav, Koren, Maya, Duek, Adrian, Rozovski, Uri, Raanani, Pia, Shacham-Abulafia, Adi
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.09.2023
• Subjects: CML; elderly; prognosis; TKI; CML; TKI; prognosis; elderly
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/S2152-2650(23)01129-1

In recent years the life expectancy in elderly patients with CML has approached that of the age-matched population and is similar to younger patients. In this study, we characterized and assessed the outcome of patients 75 years and older diagnosed with CML. A multicenter, retrospective study of consecutive patients diagnosed in Israel and the Moffitt cancer center in Florida, United States (MCC) with CML at the age of ≥ 75 years. The 1- and 5-year overall survival (OS) were calculated. Event-free survival (EFS) was defined as death, progression, or a switch to 2nd line treatment due to intolerance or resistance to 1st line therapy. We estimated the median OS of the whole cohort at the time of CML diagnosis, hereafter termed expected OS, using the life expectancy according to the central bureau of statistics (CBS). The expected and the observed median OS were plotted using Kaplan-Meier curves and were compared using Log-rank analysis. The study was approved by the local Institutional Review Boards. A total of 123 patients aged ≥ 75 years were diagnosed with CML between 2000 and 2022. The median age was 79 (range: 75 - 100) years. The median observed OS for the whole cohort was 48.5 (2.2-195) months compared to a median of 112 (27.6-150) months expected OS. OS and EFS were compared between patients receiving Imatinib vs. 2nd generation TKIs as 1st line treatment. OS was worse (71 months vs. not reached, P=0.021) for the group treated with imatinib in 1st line. EFS was similar between these groups (15 vs. 18 months, P=0.535). According to the observed OS, life expectancy was shortened in elderly patients with CML. Noteworthy, compared to patients receiving 2nd generation TKI in 1st line treatment, patients receiving Imatinib had worse OS but similar EFS. An explanation of this result could be due to physician discretion due to comorbidities or insurance issues.