The direct comparison of molecular responses of front-line imatinib (IM) monitored at the same laboratory between children and adults with chronic phase (CP) of chronic myeloid leukaemia (CML) had not been reported. In this multicenter study, we compared the landmark molecular responses and outcomes of paediatric and adult CML-CP cohorts treated with front-line IM in whom the BCR::ABL1 transcript levels were monitored at the same accredited laboratory in Taiwan.
Between June 2004 and July 2020, 55 newly diagnosed paediatric and 782 adult CML-CP patients, with molecular diagnosis and monitoring at the same reference laboratory in Taiwan, were enrolled. The criteria of 2020 European LeukemiaNet were applied to evaluate the molecular responses.
By year 5, the cumulative incidences of IS <1%, MMR, MR4.0 and MR4.5 of paediatric patients were all significantly lower than those of adult patients (58 vs 75%, 48 vs 66%, 25 vs 44%, 16 vs 34%, respectively). The 10-year progression-free survival (PFS) (90%) and overall survival (OS) (94%) of paediatric patients did not differ from those (92%) of adult patients.
We demonstrated the paediatric cohort had slower molecular responses to front-line IM and similar outcomes in 10-year PFS and OS in real-world practice.
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The datasets generated and/or analysed during this study are available from the corresponding author on reasonable request.
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The authors would like to thank Ms. Chang-Liang Lai for her technical assistance; and Drs Fang-Liang Huang, Tsung-Yen Chang, Te-Kau Chang, Tseng-Hsi Lin, Ching-Yuan Kuo, Chih-Cheng Chen, Ming-Sun Yu, Hung-I Cheng, and Yu-Shin Hung for providing patient samples.
This work was supported by grants from Chang Gung Memorial Hospital, Taiwan (CMRPG350071 and XMRPG1A0081).
The authors declare no competing interests.
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Written informed consent was obtained from the patients, parents, or guardians. Chang Gung Medical Foundation Institutional Review Board approved the study and the committee’s reference numbers are 96-0358B and 100-0927B. This study was performed in accordance with the Declaration of Helsinki.
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Liu, HC., Kuo, MC., Wu, KH. et al. Children with chronic myeloid leukaemia treated with front-line imatinib have a slower molecular response and comparable survival compared with adults: a multicenter experience in Taiwan. Br J Cancer (2023). https://doi.org/10.1038/s41416-023-02162-9