A Descriptive Study of Clinical Profile and Response to First Line Treatment in Chronic Phase of Chronic Myeloid Leukaemia

Abstract

Introduction:Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm with an incidence of 1–2 cases per 100 000 adults. It accounts for approximately 15% of newly diagnosed cases of leukemia in adults. Chronic myeloid leukaemia arises from genetic aberration in precursor haematopoietic stem cells leading to uncontrolled proliferation of myeloid cells. In initial phase, more number of differentiated myeloid cells are formed and hence disease looks quiescent. It usually affects people in their 5thor 6thdecade and forms around 15 to 20 % of all adult leukaemias.
Materials and Methods:A total of 194 patients were found, among whom 176 were in chronic phase at the time of diagnosis. Among them 14 patients who did not receive continuous treatment or lost for follow up were excluded and hence 162 patients were analysed. Details including age, sex, presenting complaints, their duration, clinical examination findings, lab results, Sokal index, general condition of patient and comorbidities were noted down and analysed.Results:Out of 194 patients 90.7 % (177 patients) presented in chronic phase. Among them 162 patients who were started on imatinib mesylate were analysed in this manuscript. Median age of patient (n=162) was 44 years (range 31-71 years). Since our department deals with adult patient’s paediatric CML were not registered. 98 (60.5 %) were male and 64 (39.5 %) were female. Table 1 shows number of patients in each age-group and majority of patients were in their 4th decade (42.59%).Conclusion:The milestones achieved in treatment of CML are numerous, but the worrisome part is that most of the patients will ultimately land up in AP or BP. Since India is a developing country, most of the centres use first generation TKI namely Imatinib, and second line TKIs are reserved for treatment failure and resistance to Imatinib.