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N Engl J Med. 2010 Dec 23;363(26):2511-21. doi: 10.1056/NEJMoa1004095.

Imatinib plus peginterferon alfa-2a in chronic myeloid leukemia.

Collaborators (208)

Roy L, Fleck E, Saulnier PJ, Marit G, Bouabdallah K, Leguay T, Schmitt A, Giovanelli HB, Kiladjian JJ, Facon T, Jouet JP, Noel MP, Ifrah N, Dib M, François S, Ame S, Lioure B, Fohrer C, Attal M, Laurent G, Recher C, Nouvel C, Huynch A, Tulliez M, Pautas-Chambon C, Kuentz M, Giraudier S, Maury S, Cordonnier C, Dubruille V, Harousseau JL, Chevallier P, Mahe B, Moreau P, Guillerm G, Dalbies F, Varet B, Buzyn A, Aouba A, Michallet M, Thomas X, Troncy J, Renaudier P, Christian B, Dorvaux V, Visanica S, Guibaud I, Cassuto JP, Karsenti JM, Gorin NC, Coppo P, Rio B, Marie JP, Legrand O, Casassus P, Fenaux P, Goldschmidt E, Bouscary D, Park S, Caillot D, Casasnovas RO, Ahwij N, Ferrant E, Lafon I, Banos A, Bauduer F, Araujo C, Larosa F, Deconinck E, Brion A, Escoffre-Barbe M, Lamy T, Dauriac C, Bernard M, Houot R, Delain M, Colombat P, Gyan E, Lenain P, Contentin N, Stamatouillas A, Leprêtre S, Schoenwald M, Alexis M, Souleau B, De Revel T, Dine G, Ammar NA, Brahimi S, Glaisner S, Janvier M, Cony-Makhoul P, Corront B, Abarah W, Frayer J, Mahfouz I, Simon M, Pollet JP, Fernandes J, Villemagne B, Maisonneuve H, Chatellier T, Priou F, Tiab M, Bonnevie F, Pignon JM, Zerazhi H, Lepeu G, Boulat O, Azzedine A, Slama B, Turlure P, Bordessoule D, Jaccard A, Remenieras L, Touati M, Moreau S, Chaury MP, Girault S, Ojeda-Uribe M, Eisenmann JC, Arkam Y, Drenou B, Blanc M, Besson C, Raphael M, Tertian G, Courby S, Bulabois CE, Gressin R, Richard B, Lavabre bertrand T, Castaigne S, Taksin AL, Fahrat H, Sohn C, Fezoui H, de Jaureguiberry JP, Gisserot O, Jardel H, Godmer P, Dutel JL, Ghomari K, Charbonnier A, Blaise D, Bouabdallah R, Vey N, Aurran-Schleinitz T, Prebet T, Vernant JP, Tona A, Choufi B, Pollet B, Reman O, Leporrier M, Macro M, Cheze S, Launay V, Jonhson-ansah H, Audhuy B, Himberlin C, Kolb B, Thyss A, Peyrade F, Plantier I, Fawaz A, Rossi JF, Quittet P, Fegueux N, Cellabos P, Navarro R, Autrand C, Morel P, Stalnikiewicz L, Dupriez B, Desablens B, Royer B, Damaj GL, Garidi R, Rodon P, Boulet JM, Berger M, Tournilhac O, Chaleteix C, DeRenzis B, Bay O, Hermet E, Aljassem-Abdelkader L, Maigre M, Etienne G, Reiffers J, Eghbali H, Joly B, Devidas A, Bouledroua S, Petitdidier C, Salanoubat C, Fouillard L, Benramdane R, Gonzales H, Vanhaeke D, Guyotat D, Mounier C, Jaubert J, Levaltier X, Giraudeau B, Salles G, Solal-Celigny P.

Author information

1
Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Lille, and INSERM Unité 837, Lille, France.

Abstract

BACKGROUND:

Imatinib (400 mg daily) is considered the best initial therapy for patients with newly diagnosed chronic myeloid leukemia (CML) in the chronic phase. However, only a minority of patients treated with imatinib have a complete molecular remission.

METHODS:

We randomly assigned 636 patients with untreated chronic-phase CML to receive imatinib alone at a dose of 400 mg daily, imatinib (400 mg daily) plus cytarabine (20 mg per square meter of body-surface area per day on days 15 through 28 of each 28-day cycle) or pegylated interferon (peginterferon) alfa-2a (90 μg weekly), or imatinib alone at a dose of 600 mg daily. Molecular and cytogenetic responses, time to treatment failure, overall and event-free survival, and adverse events were assessed. An analysis of molecular response at 12 months was planned. A superior molecular response was defined as a decrease in the ratio of transcripts of the tyrosine kinase gene BCR-ABL to transcripts of ABL of 0.01% or less, corresponding to a reduction of 4 log(10) units or more from the baseline level, as assessed by means of a real-time quantitative polymerase-chain-reaction assay.

RESULTS:

At 12 months, the rates of cytogenetic response were similar among the four groups. The rate of a superior molecular response was significantly higher among patients receiving imatinib and peginterferon alfa-2a (30%) than among patients receiving 400 mg of imatinib alone (14%) (P=0.001). The rate was significantly higher among patients treated for more than 12 months than among those treated for 12 months or less. Gastrointestinal events were more frequent among patients receiving cytarabine, whereas rash and depression were more frequent among patients receiving peginterferon alfa-2a.

CONCLUSIONS:

As compared with other treatments, the addition of peginterferon alfa-2a to imatinib therapy resulted in significantly higher rates of molecular response in patients with chronic-phase CML. (Funded by the French Ministry of Health and others; ClinicalTrials.gov number, NCT00219739.).

PMID:
21175313
DOI:
10.1056/NEJMoa1004095
[Indexed for MEDLINE]
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