Evaluation of chronic myeloid leukemia patients and their molecular responses to tyrosine kinase inhibitors in Erbil city, Iraq

Abstract

Background: Chronic myeloid leukemia (CML) is one of the indolent myeloproliferative neoplasms. It is characterized by the presence of the Philadelphia chromosome, a translocation between chromosomes 9 and 22 or BCR-ABL1 gene. Objectives: The aims of this study were to evaluate characteristics of CML patients and their molecular response to tyrosine kinase inhibitors (TKI) in Erbil city in Iraq. Patients and Methods: Seventy-six patients with CML were recruited in this retrospective and prospective study from February 2014 to March 2016, at Nanakaly Hospital for Blood Diseases in Erbil city – Kurdistan region of Iraq. They were evaluated from clinical point of view and their laboratory data, and molecular responses to TKI based on polymerase chain reaction were analyzed. Results: The median age of participants was 45 years; the male: female ratio was 1:0.9. The main presenting features were abdominal fullness in 66% and splenomegaly in 95% of patients. Nearly 66% of them had low European Treatment and Outcome Study (EUTOS) score; 70% of patient had major or complete molecular responses (MMR/CMR). There was a significant difference between patients who did versus who did not achieve MMR/CMR in hemoglobin level, promyelocyte, and myelocyte percent, EUTOS, and Sokal scores (P = 0.02, 0.006, 0.03, 0.001, and 0.02, respectively). Conclusion: In the current study, CML patients were at a younger age of onset, and more high EUTOS score. The majority of patients achieved MMR with frontline Imatinib or Nilotinib and those who switched from Imatinib to Nilotinib as well.