Various treatment responses in Imatinib treated CML patients with emphasis on marrow profile: a descriptive study in a tertiary care centre in South India

Abstract

Background: CML is a clonal stem cell neoplasm characterised by reciprocal translocation between chromosomes 9 and 22.Imatinib is used in its treatment which induces hematological, cytogenetic and molecular response. Yet, marrow response is less well defined than hematological and cytogenetic response (HR and CR). Hence our aims were1.To study the hematologic response in CML patients after 3 months of Imatinib2.To study the cytogenetic response in CML patients after 6 months of Imatinib. 3.To study and categorize morphological changes in marrow at the end of three months of treatment. Materials and methods: Forty six newly diagnosed patients of CML (BCR-ABL positive), irrespective of phase, were included. HR and CR was evaluated at the end of three months and six months of Imatinib therapy, respectively. A bone marrow aspirate and biopsy was performed at the end of three months, marrow responses were classified and parameters were analysed.Results: Of 46 patients, 91.3% of patients attained complete hematological response.30/46 patients had a follow up FISH analysis at 6 months, of whom 70% attained complete cytogenetic response(table/figure 3). Twenty nine (64.5%) of the post treatment aspirates were diluted and imprints/biopsy yielded information. Twenty eight (63%) patients showed marrow normalization, eleven (23%) persistence of disease, four (8%) progression of disease to blast crisis (BC) and three (6.5%) hypo cellular marrow.Conclusion: Post therapy BM in CML, when undertaken should have biopsy rather than an aspirate alone, as aspirates are often diluted and biopsy may yield useful information like impending blast crisis.DOI: 10.21276/APALM.1514