Abstract
To determine potential predictors of long‐term survival in a large set of Hispanic (Mexican) patients with chronic myeloid leukemia (CML) treated with imatinib. We conducted an analysis with data from 411 patients with CML treated at the National Cancer Institute – Mexico, between January 2000 and December 2016. We found a median age at diagnosis of 40 years (range: 18‐84 years). The survival rate at 150 months was 82.02%, and we found that phase at diagnosis (β: 0.447, 95% Confidence Interval [95% CI]: 0.088, 0.806; P = 0.015), prognostic scales (Sokal [P = 0.021] and Hasford [β: 0.369, 95% CI: 0.049, 0.688; P = 0.024]) and hematological response at 3 months (β: 0.717, 95% CI: 0.443, 0.991; P < 0.001), but not molecular response (P = 0.834 for 6 months, P = 0.927 for 12 months, P = 0.250 for 18 months), were independently associated with overall survival. Survival analysis in subsets, according to the initial phase (chronic, accelerated and blastic phase) did not show any effect according to prognostic scales (P > 0.05). Mexican patients with CML have repeatedly been diagnosed at earlier ages. Prognostic factors in CML may differ according to the ethnic or geographical context. We found that phase at diagnosis, prognostic scale and hematological response at 3 months were independent predictors of survival.
Highlights
Chronic myeloid leukemia (CML) is a clonal myeloproliferative expansion of primitive hematopoietic progenitors and involves the myeloid, monocytic, erythroid, megakaryocytic and, occasionally, lymphoid lineages.[1,2] Chronic myeloid leukemia was the first human disease in which a specific abnormality of the karyotype (Philadelphia chromosome, Ph+) could be related to the pathogenetic events of leukemogenesis
In this retrospective study of patients with CML treated in a national reference center—the National Cancer Institute (NCI) – Mexico—we evaluated the data collected over a period of 17 years from a large number of patients treated in a public hospital from a middle‐income country, with imatinib as a first‐line treatment
We determined that only few clinical factors, including phase at diagnosis, Sokal/Hasford risk score and hematological response at 3 months, are independent prognostic factors for long‐term survival in patients with CML
Summary
Sociodemographic, treatment, follow‐up and response characteristics of patients with CML who were treated at the NCI – Mexico from 1 January 2000 to 31 December 2016. All patients received imatinib as first line of treatment. For this type of study, informed consent was not required. We described sociodemographic and clinical characteristics of patients, showing the number of cases per category and percentages for categorical variables. Continuous variables, such as age at diagnosis, were categorized for descriptive purposes. We explored the association of sociodemographic and clinical characteristics with overall survival using Kaplan‐Meier plots and determined statistical significance using the log‐rank test. We explored independency for the association with overall survival using multiple Cox's regression models
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