Treatment and Survival in Patients with Chronic Myeloid Leukemia in a Chronic Phase in West Iran.

Mehrdad Payandeh,Masoud Sadeghi,Edris Sadeghi

doi:10.7314/apjcp.2015.16.17.7555

Mehrdad Payandeh, Masoud Sadeghi + Show 1 more

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https://doi.org/10.7314/apjcp.2015.16.17.7555

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Abstract

CML includes 30% of all leukemias, and occurs from childhood to old age. The present study was a retrospective analysis of chronic phase CML patients registered to a Hematology Clinic in Kermanshah, Iran, with checking of treatment options. Between 2002 and 2014, 85 CML patients referred to our hematology clinic were enrolled in our study. We surveyed age, sex, B-symptoms, splenomegaly, Sokal score, Hasford score, treatment and survival in all patients. Philadelphia chromosome analysis was conducted for each patient by conventional cytogenetics. We compared treatment in the patients with three drugs, imatinib, hydroxyurea (HU) and interferon alpha (IFN-α). The mean age of the patients at diagnosis was 47.5 ± 14.5 years (range, 23-82 years), with 43 (50.6%) being male. Some 13 (15.3%) were referred to our clinic for the first time with B-symptoms and 44 patients (51.8%) had splenomegaly. The Sokal score for 77 (90.6%) was low, 4 (4.7%) was intermediate and 4(4.7%) was high, but Hasford (Euro) scores for all patients were low. The 5-year survival rate for treated patients with imatinib, imatinib plus HU and imatinib plus HU plus IFN-α was 90.5%, 81.1% and 55.6%, respectively The results show that imatinib therapy alone provides better survival in CML patients compared to HU or IFN-α. Combinations of IFN-α and/or HU with imatinib probably reduce survival.

Highlights

Chronic myelogenous/myeloid leukemia (CML) the most common myeloproliferative disorder, has a characteristic t (9:22) cytogenetic abnormality that involves fusion of the BCR gene on chromosome 22 with the ABL gene on chromosome 9
The known genetic abnormality associated with CML is the condition known as Philadelphia chromosome, which occurs as a result of reciprocal translocation between chromosome 9 and 22 leading to juxta-position of BCR-ABL gene (Bhat et al, 2012)
These results show that percentage of males is more than females for CML and the mean age and median age at diagnosis for the patients in majority of studies is around 40-50 years

Summary

Introduction

Chronic myelogenous/myeloid leukemia (CML) the most common myeloproliferative disorder, has a characteristic t (9:22) cytogenetic abnormality that involves fusion of the BCR gene on chromosome 22 with the ABL gene on chromosome 9. The BCR/ABL fusion results in constitutive activation of tyrosine kinase, which leads to uncontrolled proliferation of myeloid cells. Based on clinical and hematological parameters, two prognostic scoring systems, i.e., Hasford and Sokal index scoring systems are available to predict survival duration of CML patients on Imatinib therapy (Sinha et al, 2013). In May, 2001, Imatinib, the first tyrosine kinase inhibitor (TKI) developed to block the activity of the Bcrabl protein, was approved for use in CML in the United States. The present study was a retrospective analysis of chronic phase CML patients registered to Hematology Clinic in Kermanshah, Iran, with checking of treatment.

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