Summary Imatinib has revolutionized the management of chronic‐phase chronic myeloid leukaemia (CP‐CML). This study aimed to evaluate the long‐term efficacy, safety and prognostic determinants of imatinib in a large cohort of CP‐CML patients in real‐life clinical practice. We conducted a retrospective, monocentric observational study including all adult patients with CP‐CML treated with imatinib between 2000 and 2025. Overall survival (OS), event‐free survival (EFS) and progression‐free survival (PFS) were estimated using Kaplan–Meier analysis. A total of 210 patients were included, of whom 81% received imatinib as first‐line therapy. The median follow‐up was 12.4 years. At 25 years, OS and PFS were 71% and 88% respectively. The EUTOS long‐term survival (ELTS) score independently predicted OS, EFS and PFS ( p < 0.001), while lower risk categories were associated with a faster achievement of major molecular response (MMR) and a higher probability of deep molecular response (DMR). Dose reductions were applied in 26.2% of patients, mainly older individuals with higher Charlson comorbidity index (CCI), without affecting molecular or survival outcomes. Higher CCI values correlated with inferior OS. The ELTS score remains a powerful prognostic tool for long‐term outcomes. No unexpected safety concerns were observed in the long term. Over 25 years of real‐world experience, imatinib has demonstrated sustained efficacy, safety and tolerability in CP‐CML.
Costa et al. (Thu,) studied this question.
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