ORIGINAL ARTICLE Impact of BCR-ABL mutations on response to dasatinib after imatinib failure in elderly patients with chronic-phase chronic myeloid leukemia Mario Tiribelli & Roberto Latagliata & Luigiana Luciano & Fausto Castagnetti & Antonella Gozzini & Giovanna Rege Cambrin & Mario Annunziata & Fabio Stagno & Patrizia Pregno & Francesco Albano & Elisabetta Abruzzese & Pellegrino Musto & Enrico Montefusco & Carmen Fava & Renato Fanin & Fabrizio Pane & Gianantonio Rosti & Massimo Breccia & Giuliana Alimena & Paolo Vigneri Received: 27 June 2012 / Accepted: 1 October 2012 / Published online: 10 October 2012 # Springer-Verlag Berlin Heidelberg 2012 Abstract To assess the impact of BCR-ABL kinase domain mutations on dasatinib response in elderly chronic myeloid leukemia (CML) patients, we analyzed the outcome of 76 individuals aged >60 affected by imatinib-resistant chronic- phase CML. We found that 36 cases (47 %) displayed mutations before dasatinib. Compared to non-mutated patients, subjects with point mutations had a worse response to dasatinib, with significantly lower rates of complete cytogenetic response (57 vs 32 %), higher percentage of primary resistance (16/36 vs 6/40) and a trend towards a shorter median event-free survival. Our data suggest that, in elderly patients, detection of BCR-ABL mutations negative- ly affects response to dasatinib. Keywords CML . Elderly patients . Imatinib resistance . Dasatinib . BCR-ABL mutations Electronic supplementary material The online version of this article (doi:10.1007/s00277-012-1591-2) contains supplementary material, which is available to authorized users. M. Tiribelli (*) : R. Fanin Division of Hematology and Bone Marrow Transplantation, Azienda Ospedialiero-Universitaria, P.le S. M. Misericordia, 15 - 33100 Udine, Italy e-mail: mario.tiribelli@uniud.it R. Latagliata : M. Breccia : G. Alimena Department of Cellular Biotechnology and Hematology, Sapienza University, Rome, Italy L. Luciano : F. Pane Hematology Department, Federico II University, Naples, Italy F. Castagnetti : G. Rosti Institute of Hematology L. & A. Seràgnoli, University of Bologna, Bologna, Italy A. Gozzini Department of Hematology, University of Florence, Florence, Italy G. R. Cambrin : C. Fava Department of Clinical and Biological Sciences, University of Torino, San Luigi Hospital, Orbassano, Italy M. Annunziata Division of Hematology and Stem Cell Transplantation Unit, Cardarelli Hospital, Naples, Italy F. Stagno : P. Vigneri Department of Clinical and Molecular Bio-Medicine, University of Catania, Catania, Italy P. Pregno Division of Hematology, Azienda Ospedaliera Universitaria S. Giovanni Battista, Turin, Italy F. Albano Department of Hematology, University of Bari, Bari, Italy Ann Hematol (2013) 92:179–183 DOI 10.1007/s00277-012-1591-2