Diabetic Patients With Newly Diagnosed Chronic Myeloid Leukemia: <scp>TKI</scp> Choice and Early Adverse Events. A Real‐Life Survey Within the Italian Chronic Myeloid Leukemia Network
ABSTRACT Limited data are available regarding patients with newly diagnosed chronic myeloid leukemia (CML) and concomitant diabetes mellitus (DM). Hence, we retrospectively analyzed 2149 patients with newly diagnosed chronic phase (CP) CML to compare clinical characteristics, choice of frontline therapy, early adverse events, and molecular responses between patients with or without DM. Among this cohort of 2149 patients, 241 patients (11.2%) had DM at CML diagnosis. Diabetic patients were older (median age 69.6 vs. 58.2 years, p < 0.001), showed a higher Sokal/ELTS risk and had more comorbidities, resulting in more frequent polypharmacy. Imatinib was frequently selected as first‐line treatment in diabetic patients (71% vs. 53%, p < 0.001), whereas nilotinib was more common in nondiabetics (6.2% vs. 31.9%). Discontinuation by the 12th month occurred in 24.2% of diabetic patients versus 19.4% of nondiabetics ( p = 0.031), mainly for hematologic toxicity. Diabetic patients showed a lower incidence of major molecular response (MMR) at the 12th month (55.9% vs. 68.1%, p = 0.002). Among diabetic patients, a trend toward better molecular responses was observed in patients receiving metformin ( p = 0.068). In conclusion, DM represents a clinically meaningful comorbidity in newly diagnosed CML‐CP, and seems to define a subgroup with distinct features, influencing both treatment decisions and early outcomes.
Authors
- Monica Bocchia (ORCID: https://orcid.org/0000-0003-3538-3913)
- Roberto Latagliata (ORCID: https://orcid.org/0000-0002-7741-862X)
- Alessandra Iurlo (ORCID: https://orcid.org/0000-0002-4401-0812)
- M. Trawińska
- A. Di Veroli
- Alessandro Allegra (ORCID: https://orcid.org/0000-0001-6156-8239)
- Olga Mulas (ORCID: https://orcid.org/0000-0002-7487-3328)
- Giuseppe Saglio (ORCID: https://orcid.org/0000-0002-1046-3514)
- Mario Tiribelli (ORCID: https://orcid.org/0000-0001-9449-2621)
- Iolanda Donatella Vincelli (ORCID: https://orcid.org/0000-0002-9768-698X)
- A. Malato
- Immacolata Attolico (ORCID: https://orcid.org/0000-0002-3527-3151)
- Manlio Fazio (ORCID: https://orcid.org/0000-0001-8804-2640)
- G.L. Morelli
- Luigia Luciano (ORCID: https://orcid.org/0000-0003-2255-9190)
- Isabella Capodanno (ORCID: https://orcid.org/0009-0009-7853-3310)
- Maria Cristina Miggiano (ORCID: https://orcid.org/0000-0003-1288-6104)
- Giorgina Specchia (ORCID: https://orcid.org/0000-0002-2479-9529)
- E. Crisà
- Massimiliano Bonifacio (ORCID: https://orcid.org/0000-0003-0716-1686)
- Giovanni Caocci (ORCID: https://orcid.org/0000-0002-6585-5187)
- Fabio Stagno (ORCID: https://orcid.org/0000-0002-7947-158X)
- Gianni Binotto (ORCID: https://orcid.org/0000-0003-4571-6611)
- Paolo Sportoletti (ORCID: https://orcid.org/0000-0002-5630-9862)
- Daniele Cattaneo (ORCID: https://orcid.org/0000-0002-7571-023X)
- Massimo Breccia (ORCID: https://orcid.org/0000-0003-1163-6162)
- Carmen Fava (ORCID: https://orcid.org/0000-0002-4896-981X)
- Sara Galimberti (ORCID: https://orcid.org/0000-0001-7899-5966)
- G. Loglisci
- A. Bernardelli
- Crugnola M.
- C. Elena
- M. Basile
- A. P. Leporace
- M. Pizzuti
- E. Scalzulli
- F. Cavazzini
- S. Leonetti Crescenzi
- D. Rapezzi
- S. Russo
- P. Murgano
- A. R. Scortechini
- D. Luzi
Institutions
- University of Pisa (IT)
- University of Verona (IT)
- University of Parma (IT)
- University of Udine (IT)
- University of Padua (IT)
- University of Cagliari (IT)
- University of Ferrara (IT)
- University of Pavia (IT)
- University of Perugia (IT)
- Azienda Ospedaliera San Giovanni Addolorata (IT)
- Policlinico Umberto I (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Ospedale Maggiore (IT)
- Azienda Sanitaria Unità Locale di Reggio Emilia (IT)
- Azienda ospedaliera "Bianchi-Melacrino-Morelli" (IT)
- Ospedale Vincenzo Cervello (IT)
- Ospedale San Carlo (IT)
- Nuovo Ospedale San Giovanni di Dio (IT)
- Azienda Ospedaliero Universitaria Ospedali Riuniti (IT)
- Azienda Ospedaliera S.Giuseppe Moscati (IT)
- Federico II University Hospital (IT)
- Azienda Ospedaliera Sant'Andrea (IT)
- Ospedale di Belcolle (IT)
- A. O. Ordine Mauriziano di Torino (IT)
- Azienda Ospedaliera Universitaria Senese (IT)
- Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo (IT)
- Azienda Ospedaliera Universitaria Policlinico "G. Martino" (IT)
- St. Eugenio Hospital (IT)
- Azienda Ospedaliera Ospedale Maggiore (IT)
- Policlinico San Matteo Fondazione (IT)
- Ospedale San Bortolo (IT)
- Ospedale Vito Fazzi (IT)
- University of Turin (IT)
- University of Bari Aldo Moro (IT)
Publication Details
- Journal
- European Journal Of Haematology
- Published
- 2026-07-22
- DOI
- https://doi.org/10.1111/ejh.70268
- Primary Topic
- Chronic Myeloid Leukemia Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00