Evidence map›Paper›PMID 38862792›Full record

ArticleAnnals of hematology2024

CML in the very elderly: the impact of comorbidities and TKI selection in a real-life multicenter study.

Alon Rozental, Erez Halperin, Chiya Leibovitch, Meirav Barzili, Maya Koren- Michowitz, Adrian Duek, Uri Rozovski, Martine Extermann, Pia Raanani, Adi Shacham-Abulafia

Abstract readMulticenter Study
In one paragraph

Article in Annals of hematology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Alon RozentalInstitute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Israel.
Erez HalperinInstitute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Israel.
Chiya LeibovitchInternal Medicine B, Ashdod Hospital, Samson Assuta, Ashdod, Israel.
Meirav BarziliHematology and Hemato-Oncology Division, Tel Aviv Medical Center, Tel Aviv, Israel.
Maya Koren- MichowitzFaculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Adrian DuekHematology Department, Assuta Medical Center, Ashdod, Israel.
Uri RozovskiInstitute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Israel.
Martine ExtermannSenior Adult Oncology Program, H. Lee Moffitt Cancer Center, Tampa, FL, USA.
Pia RaananiInstitute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Israel.
Adi Shacham-AbulafiaInstitute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Israel. shacham.adi@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Tyrosine kinase inhibitors (TKIs) have greatly improved chronic myeloid leukemia (CML) treatments, with survival rates close to the general population. Yet, for the very elderly, robust data remains limited. This study focused on assessing comorbidities, treatment approaches, responses, and survival for elderly CML patients. Our study was conducted on 123 elderly (≥ 75 years) CML patients across four centers in Israel and Moffitt Cancer Center, USA. The median age at diagnosis was 79.1 years, with 44.7% being octogenarians. Comorbidities were very common; cardiovascular risk factors (60%), cardiovascular diseases (42%), with a median age-adjusted Charlson Comorbidity Index (aaCCI) of 5. Imatinib was the leading first-line therapy (69%), while the use of second-generation TKIs increased post-2010. Most patients achieved a major molecular response (MMR, 66.7%), and half achieved a deep molecular response (DMR, 50.4%). Over half (52.8%) of patients moved to second-line, and nearly a quarter (23.5%) to third-line treatments, primarily due to intolerance. Overall survival (OS) was notably longer in patients with an aaCCI score below 5, and in patients who attained DMR. Contrary to expectations, the Israeli cohort showed a shorter actual life expectancy than projected, suggesting a larger impact of CML on elderly survival. In summary, imatinib remains the main initial treatment, but second-generation TKIs are on the rise among elderly CML patients. Outcomes in elderly CML patients depend on comorbidities, TKI type, response, and age, underscoring the need for personalized therapy and additional research on TKI effectiveness and safety.

Indexed as

ComorbidityLeukemia, Myelogenous, Chronic, BCR-ABL PositiveProtein Kinase InhibitorsAgedAged, 80 and overFemaleHumansImatinib MesylateIsraelMaleRetrospective StudiesSurvival RateTreatment OutcomeImatinib MesylateProtein Kinase InhibitorsChronic myeloid leukemiaComorbidityDrug toxicityGeriatric oncologySurvival analysisTreatment outcomeTyrosine kinase inhibitors

Identifiers

PMID38862792
PMCPMC11358301

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.