학술논문
Clinical Profile and Response to First Line Treatment in Chronic Phase of Chronic Myeloid Leukaemia
Original Research Article
Original Research Article
Document Type
Academic Journal
Author
Source
Journal of Evolution of Medical and Dental Sciences. December 28, 2020, Vol. 9 Issue 52, p3973, 4 p.
Subject
Language
English
ISSN
2278-4748
Abstract
BACKGROUND Chronic myeloid leukaemia arises from genetic aberration in precursor haematopoietic stem cell leading to uncontrolled proliferation of myeloid cells. In initial phase, more number of differentiated myeloid cells are [...]
BACKGROUND Chronic Myeloid Leukaemia (CML) usually occurs in the elderly population and its incidence is higher in India. Chronic Phase (CP) is treated with tyrosine kinase inhibitors (TKI) as first line until progression. Stem cell transplant is usually not done in chronic phase and it is reserved for accelerated phase and blast crisis. The exact incidence and treatment data from various institutions in India is lacking. METHODS 81 patients diagnosed with chronic phase CML in our institute over a period of 5 years were analysed from the master case records. Their clinical profile, lab parameters, response to treatment with Imatinib and side effects of treatment were analysed. Data was analysed using SPSS version 23. RESULTS Median age of patient (n = 81) was 44 years (range 31-71 years). Majority of patients presented in the 5th decade (43.2%). Left hypochondrial pain was the most common complaint (84%) followed by fatigue (80.2%). 72.8% patients had WBC count of more than a lakh, and thrombocytosis in present in 63%. Median blast count was 1.8 %. 18 (22.2%), 52 (64.2%) and 11 (13.6%) patients (n = 81) had low, intermediate and high Sokal index respectively. CHR was achieved in 87.7% of patients (n = 71) at 3 months. 92.6% (74 patients) achieved CHR at 6 months. Median time to achieve CHR was 39 days. 2.5 year Progression free Survival (PFS) was 67.9% and 2.5 year Overall Survival (OS) was 72.8% combining all 3 risk categories in Sokal index. Most common toxicity was anaemia and its seen in 39.5% (32 patients) followed by Thrombocytopenia seen in 30.9% (25 patients). CONCLUSIONS Imatinib showed good response with manageable side effects in chronic phase CML in our institute. It is cost effective especially in the low socioeconomic group. KEY WORDS Chronic Myeloid Leukaemia, CML, Imatinib, Side Effects, First Line Treatment, Complete Hematologic Response, Progression Free Survival, Overall Survival
BACKGROUND Chronic Myeloid Leukaemia (CML) usually occurs in the elderly population and its incidence is higher in India. Chronic Phase (CP) is treated with tyrosine kinase inhibitors (TKI) as first line until progression. Stem cell transplant is usually not done in chronic phase and it is reserved for accelerated phase and blast crisis. The exact incidence and treatment data from various institutions in India is lacking. METHODS 81 patients diagnosed with chronic phase CML in our institute over a period of 5 years were analysed from the master case records. Their clinical profile, lab parameters, response to treatment with Imatinib and side effects of treatment were analysed. Data was analysed using SPSS version 23. RESULTS Median age of patient (n = 81) was 44 years (range 31-71 years). Majority of patients presented in the 5th decade (43.2%). Left hypochondrial pain was the most common complaint (84%) followed by fatigue (80.2%). 72.8% patients had WBC count of more than a lakh, and thrombocytosis in present in 63%. Median blast count was 1.8 %. 18 (22.2%), 52 (64.2%) and 11 (13.6%) patients (n = 81) had low, intermediate and high Sokal index respectively. CHR was achieved in 87.7% of patients (n = 71) at 3 months. 92.6% (74 patients) achieved CHR at 6 months. Median time to achieve CHR was 39 days. 2.5 year Progression free Survival (PFS) was 67.9% and 2.5 year Overall Survival (OS) was 72.8% combining all 3 risk categories in Sokal index. Most common toxicity was anaemia and its seen in 39.5% (32 patients) followed by Thrombocytopenia seen in 30.9% (25 patients). CONCLUSIONS Imatinib showed good response with manageable side effects in chronic phase CML in our institute. It is cost effective especially in the low socioeconomic group. KEY WORDS Chronic Myeloid Leukaemia, CML, Imatinib, Side Effects, First Line Treatment, Complete Hematologic Response, Progression Free Survival, Overall Survival