• Annals of medicine · Dec 2022

    Outcomes of adolescents and young adults with chronic-phase chronic myeloid leukaemia treated with tyrosine kinase inhibitors.

    • Yuriko Nishiyama-Fujita, Tomonori Nakazato, Noriyoshi Iriyama, Michihide Tokuhira, Maho Ishikawa, Eriko Sato, Tomoiku Takaku, Keiji Sugimoto, Hiroyuki Fujita, Isao Fujioka, Shun Tsuchiya, Yuta Kimura, Eisaku Iwanaga, Norio Komatsu, Norio Asou, Masahiro Kizaki, Yoshihiro Hatta, and Tatsuya Kawaguchi.
    • Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
    • Ann. Med. 2022 Dec 1; 54 (1): 1244-1254.

    IntroductionFew studies have reported the outcomes of adolescents and young adults (AYAs) with chronic-phase chronic myeloid leukaemia (CML-CP) on tyrosine kinase inhibitors (TKIs).Materials And MethodsWe retrospectively analysed the clinical features, treatment response, and long-term outcomes of 42 AYA patients, in comparison to older patients. The initial therapies of AYA patients between 2001 and 2016 included imatinib (n = 24), dasatinib (n = 13) and nilotinib (n = 5).ResultsIn AYA patients, the peripheral blood (PB) white blood cell count and percentage of blasts at the diagnosis were significantly higher, haemoglobin levels were lower and the spleen size was larger. The major molecular response (MMR), event-free survival (EFS) and overall survival (OS) rates were comparable. A sub-analysis comparing imatinib to second-generation TKIs as the initial therapy also showed that their prognosis was comparable.DiscussionIn conclusion, the tumour burden at the diagnosis of CML-CP is higher in AYA patients; however, their prognosis was not worse in comparison to older patients treated with TKIs. KEY MESSAGESFew studies have reported the outcomes of adolescents and young adults (AYAs) with chronic-phase chronic myeloid leukaemia (CML-CP) on tyrosine kinase inhibitors (TKIs). This study showed the tumour burden at the diagnosis of CML-CP is higher in AYA pa tients; however, their prognosis was not worse in comparison to older patients treated with TKIs. Understanding the biological and non-biological features of AYA patients with CML-CP on TKI therapy is essential for better management and to improve the outcomes.

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