Chronic Myeloid Leukemia
Conditions
Keywords
BCR::ABL,, Chronic myeloid leukemia,, Tyrosine kinase inhibitor,, T315I mutation
Brief summary
A retrospective multi-center cohort study design was used to address the study objectives, using medical records obtained from three clinical centers in France.
Detailed description
The index date for patients in the 3L cohort was defined as the date of initiation of 3L therapy. The index date for the T315I cohort was defined as the date of treatment initiation with TKI or allogeneic stem cell transplantation (allo-SCT) after identification of T315I mutation status. The baseline (i.e., pre-index) period was defined as the 6 months prior to the index date, and the post-index period was defined as the time from the index date to the date of last patient contact or patient death. Patients who were alive at the end of the follow-up period were censored at the date of last contact.
Interventions
OTHERT315I
Patients with chronic myeloid leukemia with T315I mutation
OTHER3L Therapy
Treatments received in 3L were dasatinib, nilotinib, imatinib, ponatinib, bosutinib, and allo-SCT
Sponsors
Novartis Pharmaceuticals
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosed with CML-CP * Age ≥18 years at the time of CML-CP diagnosis * For 3L patients: initiated one of the following 3L therapies in CML-CP after failing on ≥2 TKIs (i.e., bosutinib, dasatinib, imatinib, nilotinib, or ponatinib) or allo-SCT * For T315I mutation patients: evidence of T315I mutation and treatment with TKI or allo-SCT
Exclusion criteria
* History of other active malignancies within the 3 years prior to the time of CML-CP diagnosis * Documentation of anti-cancer therapies for any other malignancies prior to the time of 3L therapy initiation or at the time of treatment initiation after identification of T315I mutation * Enrollment in a clinical trial at the time of 3L therapy initiation or at the time of treatment initiation after identification of T315I mutation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients: Year patient initiated third-line treatment | throughout the study (study used data from 2000 to 2021) | Following categories included: Before 2010 2010-2014 2015-2019 2020-2021 |
| Duration of third-line treatment | throughout the study (study used data from 2000 to 2021) | Duration of third-line treatment was reported |
| Number of patients: Type of therapy received in third-line treatment | throughout the study (study used data from 2000 to 2021) | * TKI agent * Allo-SCT |
| Time from 2L discontinuation to third-line treatment initiation | throughout the study (study used data from 2000 to 2021) | Time from 2L discontinuation to third-line treatment initiation was reported |
| Number of patients still on 3L therapy as of data collection date | throughout the study (study used data from 2000 to 2021) | Number of patients still on 3L therapy as of data collection date was reported |
| Number of patients discontinued 3L | throughout the study (study used data from 2000 to 2021) | Number of patients who discontinued 3L treatment were reported |
| Number of patients: Reasons for 3L discontinuation | throughout the study (study used data from 2000 to 2021) | * Treatment switch due to AEs or intolerance * Treatment switch due to resistance * Treatment switch due to signs of ineffectiveness * Treatment switch due to other reasons |
| Number of lines of therapy for patients with chronic myeloid leukemia in third-line treatment | throughout the study (study used data from 2000 to 2021) | Number of lines of therapy for patients with chronic myeloid leukemia in third-line treatment were reported |
| Number of most frequent treatment sequences for patients with chronic myeloid leukemia in third-line treatment | throughout the study (study used data from 2000 to 2021) | Number of most frequent treatment sequences for patients with chronic myeloid leukemia in third-line treatment were reported |
| Number of last line of therapy for patients with chronic myeloid leukemia in third-line treatment | throughout the study (study used data from 2000 to 2021) | Number of last line of therapy for patients with chronic myeloid leukemia in third-line treatment were reported |
| Number of patients: Year patient initiated on the line identified as T315I line of interest | throughout the study (study used data from 2000 to 2021) | Following categories included: Before 2010 2010-2014 2015-2019 |
| Duration of the line identified as T315I line of interest | throughout the study (study used data from 2000 to 2021) | Duration of the line identified as T315I line of interest was reported |
| Number of patients: Type of therapy received in the line identified as T315I line of interest | throughout the study (study used data from 2000 to 2021) | * TKI agent * Allo-SCT |
| Number of patients still on line of therapy identified as T315I line of interest as of data collection date | throughout the study (study used data from 2000 to 2021) | Number of patients still on line of therapy identified as T315I line of interest as of data collection date were reported |
| Number of patients: Reasons for discontinuation on the line identified as T315I line of interest | throughout the study (study used data from 2000 to 2021) | * Adverse events or intolerance * Resistance * Signs of ineffectiveness Suboptimal response Progression to accelerated phase or blast phase * Other reasons Acquired mutations |
| Number of lines of therapy for patients with chronic myeloid leukemia with T315I mutation | throughout the study (study used data from 2000 to 2021) | Number of lines of therapy for patients with chronic myeloid leukemia with T315I mutation were reported |
| Number of line identified as T315I line of interest | throughout the study (study used data from 2000 to 2021) | Number of line identified as T315I line of interest were reported |
| Number of treatment sequence for patients with chronic myeloid leukemia with T315I mutation | throughout the study (study used data from 2000 to 2021) | Number of treatment sequence for patients with chronic myeloid leukemia with T315I mutation were reported |
| Number of last line of therapy for patients with chronic myeloid leukemia with T315I mutation | throughout the study (study used data from 2000 to 2021) | Number of last line of therapy for patients with chronic myeloid leukemia with T315I mutation were reported |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients: Smoking status at index date of patients with chronic myeloid leukemia in third-line treatment | Index date defined as the date of initiation of 3L therapy (data from 2000 to 2021) | Smoking status at index date of patients with chronic myeloid leukemia in third-line treatment was reported. |
| Time from CML-CP diagnosis to index date (month) of patients with chronic myeloid leukemia in third-line treatment | throughout the study (study used data from 2000 to 2021) | Time from CML-CP diagnosis to index date (month) of patients with chronic myeloid leukemia in third-line treatment was reported. |
| Number of patients with Hasford score at CML-CP diagnosis (month) of patients with chronic myeloid leukemia in third-line treatment | throughout the study (study used data from 2000 to 2021) | Low risk (≤780) Intermediate risk (\>780 to ≤1480) High risk (\>1480) Not assessed Unknown / not sure |
| Number of patients with Sokal score at CML-CP diagnosis (month) of patients with chronic myeloid leukemia in third-line treatment | throughout the study (data source from 2000 to 2021) | Low risk (\<0.8) Intermediate risk (≥0.8 to ≤1.2) High risk (\>1.2) Not assessed Unknown / not sure |
| Number of patients with ELTS risk score at CML-CP diagnosis (month) of patients with chronic myeloid leukemia in third-line treatment | throughout the study (data source from 2000 to 2021) | ELTS: EUTOS long-term survival Low risk (≤1.5680) Intermediate risk (\>1.5680 to ≤2.2185) High risk (\>2.2185) Not assessed Unknown / not sure |
| Number of patients with BCR::ABL1 rearrangement at CML-CP diagnosis of patients with chronic myeloid leukemia in third-line treatment | throughout the study (data source from 2000 to 2021) | Major Minor Other |
| Number of patients with Additional chromosomal abnormalities at CML-CP diagnosis of patients with chronic myeloid leukemia in third-line treatment | throughout the study (study used data from 2000 to 2021) | Yes No |
| Number of comorbid conditions prior to the index date in patients with chronic myeloid leukemia in third-line treatment | Baseline (6 months prior to index date, defined as the date of initiation of 3L therapy) | Number of comorbid conditions prior to the index date in patients with chronic myeloid leukemia in third-line treatment were reported. |
| Number of patients with comorbid conditions prior to the index date in patients with chronic myeloid leukemia in third-line treatment | Baseline (6 months prior to index date, defined as the date of initiation of 3L therapy) | Cardiovascular disease Pulmonary disease/pulmonary arterial hypertension Gastrointestinal issues Renal disease Diabetes Liver disease Other No comorbidities Unknown / not sure |
| Number of patients with any ischemic condition prior to the index date in patients with chronic myeloid leukemia in third-line treatment | Baseline (6 months prior to index date, defined as the date of initiation of 3L therapy) | Cardiovascular disease Cerebrovascular disease Peripheral arterial |
| Number of patients with Cardiovascular risk factors prior to the index date in patients with chronic myeloid leukemia in third-line treatment | Baseline (6 months prior to index date, defined as the date of initiation of 3L therapy) | Hypertension Hyperlipidemia/dyslipidemia Diabetes Obesity |
| Laboratory and clinical results: Random blood glucose (mg/dl) | throughout the study (study used data from 2000 to 2021) | Laboratory and clinical results were reported. |
| Laboratory and clinical results: Fasting blood glucose (mg/dl) | throughout the study (study used data from 2000 to 2021) | Laboratory and clinical results were reported. |
| Laboratory and clinical results: LDL cholesterol (mg/dl) | throughout the study (study used data from 2000 to 2021) | Laboratory and clinical results were reported. |
| Laboratory and clinical results: Total cholesterol (mg/dl) | throughout the study (study used data from 2000 to 2021) | Laboratory and clinical results were reported. |
| Laboratory and clinical results: Blood pressure | throughout the study (study used data from 2000 to 2021) | Laboratory and clinical results were reported. |
| Laboratory and clinical results: Spleen size below costal margin | throughout the study (study used data from 2000 to 2021) | Laboratory and clinical results were reported. |
| Cytogenetic response (CyR) for 3L patients | 12 and 24 months | CCyR, defined as an absence of Philadelphia chromosome-positive (Ph+) metaphases in bone marrow cytogenetics |
| Laboratory and clinical results: Bone marrow differential cell count | throughout the study (study used data from 2000 to 2021) | Laboratory and clinical results were reported. |
| Number of patients with BCR::ABL1 mutation status by line of therapy for patients with chronic myeloid leukemia in third-line treatment | throughout the study (study used data from 2000 to 2021) | Laboratory and clinical results were reported. |
| Proportion of patients achieving response among patients with chronic myeloid leukemia with T315I mutation | throughout the study (study used data from 2000 to 2021) | Laboratory and clinical results were reported. |
| Laboratory and clinical results: Blood cell count | throughout the study (study used data from 2000 to 2021) | Laboratory and clinical results were reported. |
| Proportion of patients achieving response among patients with chronic myeloid leukemia in third-line treatment in 12 months | 12 months post treatment | Proportion of patients achieving response among patients with chronic myeloid leukemia in third-line treatment in 12 months were reported |
| Proportion of patients achieving response among patients with chronic myeloid leukemia in third-line treatment in 24 months | 24 months post treatment | Proportion of patients achieving response among patients with chronic myeloid leukemia in third-line treatment in 24 months were reported. |
| Proportion of patients achieving sustained molecular responses among patients with chronic myeloid leukemia in third-line treatment in 12 months | 12 months post treatment | Proportion of patients achieving sustained molecular responses among patients with chronic myeloid leukemia in third-line treatment in 12 months were reported. |
| Proportion of patients achieving sustained molecular responses among patients with chronic myeloid leukemia in third-line treatment in 24 months | 24 months post treatment | Proportion of patients achieving sustained molecular responses among patients with chronic myeloid leukemia in third-line treatment in 24 months were reported. |
| Time to major molecular response (MMR) among patients with chronic myeloid leukemia in third-line treatment | 12, 24, 36, 48, 60, 72 and 84 months post treatment | Time to MMR was defined as the time from third-line (3L) treatment initiation to the time patients achieved MMR (i.e., 0.01% IS \< BCR::ABL1 transcript level ≤ 0.1% IS). Patients were censored at the earliest of treatment discontinuation or switch, loss to follow-up, end of data availability, or death. |
| Time to deep molecular response (MR4.0) among patients with chronic myeloid leukemia in third-line treatment | 12, 24, 36, 48, 60, 72 and 84 months post treatment | Time to MR4.0 was defined as the time from third-line (3L) treatment initiation to the time patients achieved MR4.0 (i.e., 0.0032% IS \< BCR::ABL1 transcript level ≤ 0.01% IS). Patients were censored at the earliest of treatment discontinuation or switch, loss to follow-up, end of data availability, or death. |
| Time to sustained deep molecular response (MR4.0) among patients with chronic myeloid leukemia in third-line treatment | 12, 24, 36, 48, 60, 72 and 84 months post treatment | Time to sustained MR4.0 was defined as the time from third-line (3L) treatment initiation to the time patients achieved sustained MR4.0 or better (i.e., BCR::ABL1 ≤ 0.01%) in all consecutive assessments performed for at least 12 months (i.e., 365.25 days). Patients were censored at the earliest of treatment discontinuation or switch, loss to follow-up, end of data availability, or death. |
| Time to deep molecular response (MR4.5) among patients with chronic myeloid leukemia in third-line treatment | 12, 24, 36, 48, 60, 72 and 84 months post treatment | Time to MR4.5 was defined as the time from third-line (3L) treatment initiation to the time patients achieved MR4.5 (i.e., 0.001% IS ≤ BCR::ABL1 transcript level ≤ 0.0032% IS). Patients were censored at the earliest of treatment discontinuation or switch, loss to follow-up, end of data availability, or death. |
| Time to sustained deep molecular response (MR4.5) among patients with chronic myeloid leukemia in third-line treatment | 12, 24, 36, 48, 60, 72 and 84 months post treatment | Time to sustained MR4.5 was defined as the time from third-line (3L) treatment initiation to the time patients achieved sustained MR4.5 or better (i.e., BCR::ABL1 ≤ 0.0032%) in all consecutive assessments performed for at least 2 years (i.e., 730.5 days). Patients were censored at the earliest of treatment discontinuation or switch, loss to follow-up, end of data availability, or death. |
| Time to Progression-free survival (PFS) for 3L patients | 12, 24, 36, 48, 60, 72 and 84 months post treatment | Time to PFS was defined as the time from third-line treatment initiation to earliest occurrence of documented disease progression to accelerated phase or blast crisis, or the date of death from any cause. Patients were censored at the earliest of treatment discontinuation or switch, loss to follow-up, or end of data availability. |
| Time to Overall Survival (OS) for 3L patients | 12, 24, 36, 48, 60, 72 and 84 months post treatment | Time to OS was defined as the time from third-line treatment initiation to death from any cause. Patients were censored at the earliest of treatment discontinuation or switch, date of last follow-up, or end of data availability. |
| Time to treatment discontinuation (TTD) for 3L patients | 12, 24, 36, 48, 60, 72 and 84 months post treatment | TTD was defined as the time from third-line treatment initiation to treatment discontinuation or switch. Patients were censored at the earliest of loss to follow-up, or end of data availability, or death |
| Proportion of patients with Adverse Events (AEs) in third-line treatment | throughout the study (study used data from 2000 to 2021) | Proportion of patients with Adverse Events (AEs) were reported to evaluate the safety profile of third-line treatments for chronic myeloid leukemia |
| Age of patients with chronic myeloid leukemia in third-line treatment | Index date defined as the date of initiation of 3L therapy (data from 2000 to 2021) | Age information was reported. |
| Number of patients: Year of chronic myeloid leukemia in chronic phase (CML-CP) diagnosis of patients with chronic myeloid leukemia in third-line treatment | throughout the study (study used data from 2000 to 2021) | Year of CML-CP diagnosis of patients with chronic myeloid leukemia in third-line treatment was reported. |
| Sex of patients with chronic myeloid leukemia in third-line treatment | Index date defined as the date of initiation of 3L therapy (data from 2000 to 2021) | Sex information was reported. |
| Number of patients: Medical center of patients with chronic myeloid leukemia in third-line treatment | Index date defined as the date of initiation of 3L therapy (data from 2000 to 2021) | The following centers were included: Centre Léon Bérard, Lyon Hématologie Institut Bergonié, Bordeaux Institut Universitaire du Cancer Toulouse, Toulouse |
| Length of follow-up (month) characteristics of patients with chronic myeloid leukemia in third-line treatment | throughout the study (study used data from 2000 to 2021) | Length of follow-up was defined as time from index date to the date of last known contact with patient or patient death. |
Countries
France
Outcome results
None listed