Comorbidities and polypharmacy impact on complete cytogenetic response in chronic myeloid leukaemia elderly patients

BACKGROUND: In older patients comorbidity and polypharmacy can significantly influence the success of the treatment, as well as the cognitive and psycho-social aspects. A significant proportion of chronic myeloid leukaemia (CML) patients are "elderly": in the past the aim of therapy in this subset of patients was only to contain the leukaemic mass, but nowadays, with the advent of the protein-tyrosine kinase inhibitors, also elderly patients can access these treatments. We want to assess if even old CML patients, with a correct geriatric evaluation, can be successfully treated with protein-tyrosine kinase inhibitors. METHODS: A complete geriatric evaluation in 16 old CML patients aged >65years treated with TKI was performed in order to assess the comorbidity, the polypharmacy and the cognitive, physical and psychological states. The Charlson comorbity index (CCI) and the polypharmacy were correlated to the obtained cytogenetic response. Seven scales of geriatric evaluation were used to assess the autonomy of patients before they were included into the study. RESULTS: In our cohort of elderly patients treated with imatinib, comorbidities and polypharmaco-therapy demonstrated an influence on TKI therapeutic success. In fact, the majority of complete cytogenetic response was obtained by patients who presented a low score of CCI and did not take any other drugs other than TKI. CONCLUSION: Also old chronic myeloid leukaemia patients can benefit from TKI treatment if a good cooperation between the haematologist and the geriatrician is established.