1105 - Management of Pediatric Chronic Myeloid Leukemia: Experience from Eastern India

Abstract

ABSTRACT Imatinib inhibits constitutively active BCR-ABL tyrosine kinase of chronic myeloid leukemia (CML). It is a novel molecule, which inhibits the protein product of this fusion gene and hence has been used in the treatment of CML. In a long term -term study it was found superior to interferon alfa plus cytarabine for newly diagnosed CML in the chronic phase. However, till date there is no major study to evaluate Eastern Indian patients with CML treated with imatinib mesylate. The present study evaluates 138 patients with CML treated with imatinib mesylate. Of these, 33 patients had to be excluded due to various reasons of noncompliance, death and not being fit to receive the drug. Among rest 105 patients, 95 was in chronic phase, 7 in accelerated phase and 3 patients had blast crisis at the time of presentation. Among 105 patients, 45 patients received either interferon alpha or hydroxyurea and other 60 patients were previously untreated. Complete hematological remission rate and major cytogenetic response (CGR) rates were 90% and 50%, respectively after 1 year of treatment. Complete molecular remission rate was 35% after 1 year of treatment. The number of imatinib resistant patients is 8, about 7.6 % of total included patients. The disease free and overall survival at 51 months are 75.5 and 81.5% respectively. Oedema, diarrhoea, abdominal pain, dermatitis, mucositis, neutropenia and thrombocytopenia were some of the major toxicities. After 51 months of follow-up, continuous treatment of chronic-phase CML with imatinib as initial therapy was found to be safe and able to induce durable responses in a high proportion of patients. Thus it can be concluded that imatinib therapy in pediatric patients can replace bone marrow transplantation. Disclosure All authors have declared no conflicts of interest.