RETROSPECTIVE ANALYSIS OF CHRONIC MYELOID LEUKEMIA PATIENTS IN TRAKYA UNIVERSITY SCHOOL OF MEDICINE

Yıl 2019, Cilt: 6 Sayı: 3, 70 - 74, 30.10.2019

Fatih Erkan Akay , Beliz Koçyiğit , Berfin Tan , Emine İkbal Atlı , Volkan Baş Hakkı Onur Kırkızlar

Öz

Aims: This study aims to establish the data; including demographic features, molecular response status, disease characteristics, and survival rate of chronic myeloid leukemia patients treated with tyrosine kinase inhibitors in Trakya University School of Medicine. Methods: In this study, the data of 102 patients over 18 years old who were diagnosed with chronic myeloid leukemia in Trakya University School of Medicine between January 2003-October 2019 were analyzed retrospectively. Data was analyzed using SPSS 23.0.0.0. Results: The total number of patients in the study was 102. There were 95 (93.1%) patients on chronic phase and 6 (5.9%) patients on accelerated phase. Eighty-three (81.4%) of the patients had at least a major molecular response and 17 (16.7%) patients could not achieve at least a major molecular response. Conclusion: As our study showed, first line treatment with imatinib may not be enough for some of the patients to recover and therefore different TKIs such as dasatinib, nilotinib, bo-sutinib, and ponatinib are being used in the treatment of CML. Inadequate response, drug side effects and incompliances are the causes of switching the drug choice. Further studies are needed to thoroughly reveal the epidemiology and treatment regimens.Keywords: Chronic myeloid leukemia, tyrosine kinase, neoplasms

Anahtar Kelimeler

Chronic myeloid leukemia, tyrosine kinase, neoplasms

Kaynakça

• 1. Faderl S, Talpaz M, Estrov Z et al. The biology of chronic myeloid leukemia. New England Journal of Medicine 1999;341(3):164–72.
• 2. Kurzrock G, Gutterman J, Talpaz M. The molecular genetics of Philadelphia chromosome-positive leukemias. N Engl J Med 1988;319:990-8.
• 3. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018;68:7–30.
• 4. Braziel RM, Shipp MA, Feldman AL et al. Molecular diagnostics. Hematology 2003;(1):279-93.
• 5. Baccarani M, Deininger MW, Rosti G et al. European Leukemia-Net recommendations for the management of chronic myeloid leu-kemia: 2013. Blood 2013;122(6):872–84.
• 6. Radich JP, Deininger M, Abboud CN et al. Chronic myeloid leu-kemia, version 1.2019, NCCN clinical practice guidelines in on-cology. Journal of the National Comprehensive Cancer Network 2019;16:1108–35.
• 7. Hanfstein B, Müller MC, Hehlmann R et al. Early molecular and cytogenetic response is predictive for long-term rogression-free and overall survival in chronic myeloid leukemia (CML). Leukemia 2012;26:2096–102.
• 8. Hochhaus A, Saussele S, Rosti G et al. Chronic myeloid leukaemia: ESMO clinical practice guidelines for diagnosis, treatment and fol-low-up. Annals of Oncology 2017;28(4):41-51.
• 9. Sahin F, Saydam G, Comert M et al. Turkish chronic myeloid leu-kemia study: retrospective sectional analysis of CML patients. Turk J Hematol 2013;30:351-8.
• 10. O’Brien SG, Guilhot F, Larson RA et al. Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chro-nic-phase chronic myeloid leukemia. N Engl J Med 2003;348:994-1004.
• 11. Druker BJ, Guilhot F, O’Brien SG et al. Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. N Engl J Med 2006;355:2408-17.
• 12. Roy L, Guilhot J, Krahnke T et al. Survival advantage from imati-nib compared with combination interferon-alpha plus cytarabine in chronic-phase chronic myelogenous leukemia: historical comparison between two phase 3 trials. Blood 2006;108:1478-84.ü
• 13. Bittencourt H, Funke V, Fogliatto L et al. Imatinib mesylate versus allogeneic BMT for patients with chronic myeloid leukemia in first chronic phase. Bone Marrow Transplant 2008;42:597-600.
• 14. National Cancer Institute. Surveillance, Epidemiology, and End Results Program. (online) (cited 2019 August 5). Available from: UR-L:https://seer.cancer.gov.
• 15. Jabbour E, Kantarjian H. Chronic myeloid leukemia: 2018 update on diagnosis, therapy and monitoring. Am J Hematol 2018;93(3):442-59.
• 16. Shanmuganathan N, Hiwase DK, Ross DM. Treatment of chronic myeloid leukemia: assessing risk, monitoring response, and optimizing outcome. Leukemia & Lymphoma 2017;58(12):2799–810.
• 17. Russo RA, Breccia M, Abruzzese E et al. Outcome of 82 chro-nic myeloid leukemia patients treated with nilotinib or dasatinib after failure of two prior tyrosine kinase inhibitors. Haematologica 2013;98:399–403.
• 18. Khoury HJ, Cortes JE, Kantarjian HM et al. Bosutinib is active in chronic phase chronic myeloid leukemia after imatinib and dasatinib and/or nilotinib therapy failure. Blood 2012;119:3403–12.