REAL LIFE DATA OF CHRONIC MYELOID LEUKEMIA PATIENTS IN ISPARTA

Abstract

Objective Chronic myeloid leukemia is a myeloproliferative neoplasm with an incidence of 1–2 cases per 100 000 adults. Central to the pathogenesis of CML, is the fusion of the Abelson murine leukemia (ABL1) gene on chromosome 9 with the breakpoint cluster region (BCR) gene on chromosome 22. The therapeutic landscape changed dramatically with the development of the tyrosine kinase inhibitors (TKIs). This “targeted” approach altered the natural history of CML, improving the 10-year survival rate to 80-90%. This study aims to investigate the effective management of TKI treatment and overall survival in “real-life” CML patients and to discuss the results with current literature. Material and Method Fifty-eight patients who were diagnosed as CML between 2000 and 2018 in Suleyman Demirel University Hematology Department were evaluated. Patients’ clinical and laboratory characteristics, clinical and demographical features, treatment options, side effects and responses were evaluated in this study. Risk assessment and staging applied with World Health Organization criteria and Sokal Hasford and Eutos risk scoring system. We determined hematological, cytogenetic and molecular response according to European Leukemia Network criteria. Results The average age, male / female ratio and survival rates were found similar to those in literature. The age distribution (p = 0,001) and Charlson comorbidity index (p = 0.005) and Charlson comorbidity-age index (p = 0,000) had a statistically significant effect on overall survival. Age distribution (p = 0,029), Charlson comorbidity age index (p = 0,001) and major molecular response at 12 months (p = 0,028) were found to have a significant effect on disease-free survival. Major molecular response at 12 months (p = 0,006) also had a statistically significant effect on progression-free survival. Reticular fiber grade did not significantly affect overall survival, disease-free survival and progressionfree survival of patients. Conclusion These results suggest that CML is generally well managed with existing treatment options and that death occur more frequently due to other medical problems. In CML, Charlson indices have been shown to be significantly associated with overall survival and disease-free survival.