Dasatinib treatment long-term results among imatinib-resistant/intolerant patients with chronic phase chronic myeloid leukemia are favorable in daily clinical practice
LEUKEMIA & LYMPHOMA
Authors: Zackova, Daniela; Klamova, Hana; Belohlavkova, Petra; Stejskal, Lukas; Necasova, Tereza; Semerad, Lukas; Weinbergerova, Barbora; Srbova, Dana; Voglova, Jaroslava; Cicatkova, Petra; Sustkova, Zuzana; Hornak, Tomas; Baranova, Jana; Prochazkova, Jirina; Mayer, Jiri
Abstract
To evaluate long-term real-life results of dasatinib therapy among chronic phase chronic myeloid leukemia patients resistant or intolerant to imatinib, we retrospectively analyzed data of 118 patients treated in centers participating in the database INFINITY. With median follow-up of 37 months, estimated 5-year cumulative incidences of complete cytogenetic and major molecular responses were 78% and 68%, respectively. The estimated 5-year probability of overall survival (OS) and event-free survival (EFS) were 86% and 83%, respectively. Both OS and EFS were significantly improved among patients withBCR-ABL1transcript level <= 10% at 3 months. Dasatinib toxicity was tolerable however persistent in almost half our patients, even after years of therapy. Pleural effusion occurred in 29% of patients and was responsible for 30% of dasatinib discontinuations. Our results confirmed very good efficacy and acceptable toxicity of dasatinib in second line setting and support the evidence and importance of high-quality real-life CML patient management.
Hematological malignancies in East Africa-Which cancers to expect and how to provide services
PLOS ONE
Authors: Leak, Steven Alan; Mmbaga, Lilian Gasper; Mkwizu, Elifuraha Wilson; Mapendo, Priscus John; Henke, Oliver
Abstract
Background Sub-Saharan Africa (SSA) has an increasing non-communicable disease burden. Tanzania has an incidence of more than 35,000 cancer cases per year with an 80% mortality rate. Hematological malignancies account for 10% of these cases. The numbers will double within the next 10 years due to demographic changes, better diagnostic capabilities and life style changes. Kilimanjaro Christian Medical Centre established a Cancer Care Centre (CCC) in December 2016 for a catchment area of 15 million people in Northern Tanzania. This article aims to display the hematological diagnosis and characteristics of the patients as well as to describe the advancements of hematologic services in a low resource setting. Methods A cross-sectional analysis of all hematological malignancies at CCC from December 2016 to May 2019 was performed and a narrative report provides information about diagnostic means, treatment and the use of synergies. Results A total of 209 cases have been documented, the most common malignancies were NHL and MM with 44% and 20%. 36% of NHL cases, 16% of MM cases and 63% of CML cases were seen in patients under the age of 45. When subcategorized, CLL/SLL cases had a median age was 56.5, 51 years for those with other entities of NHL. Sexes were almost equally balanced in all NHL groups while clear male predominance was found in HL and CML. Discussion Malignancies occur at a younger age and higher stages than in Western countries. It can be assumed that infections play a key role herein. Closing the gap of hematologic services in SSA can be achieved by adapting and reshaping existing infrastructure and partnering with international organizations.