KRONİK FAZ KRONİK MYELOİD LÖSEMİDE HEDEFE YÖNELİK TEDAVİNİN GERÇEK HAYATTA UZUN DÖNEM İZLEM SONUÇLARI: TEK MERKEZ DENEYİMİ

Year 2019, Volume: 52 Issue: 1, 59 - 63, 14.03.2019

Ali Hakan Kaya

Abstract

Amaç: Kronik myeloid lösemi (KML),
myeloid seri hücrelerinde aşırı ve kontrolsüz çoğalmayla karakterize olan bir
hematopoetik kök hücre hastalığıdır. Tirozin kinaz inhibitörleri (TKİ) ile KML
tedavisinde başarı yüksek oranda artmıştır. Bu hastaların uzun dönem takibinde
hedefe yönelik tedavinin yan etki yönetimi, yanıt kaybı ve ilaca direnç
mekanizmalarının yakından izlemi klinik pratikte önem kazanmıştır. Bu çalışmada
da ünitemizde tedavi alan ve takip altında olan kronik faz KML hastalarının
klinik seyirlerinin geriye dönük değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntem: Haziran 2001 - Aralık 2016
tarihleri arasında tanı almış, TKİ ile tedavi edilen 72 kronik faz KML
olgusunun sonuçları geriye dönük olarak değerlendirilmiştir.

Bulgular: Çalışmaya tanı anı medyan yaşı
40 (16-66) olan 36 (%50)’sı kadın ve 36 (%50)’sı erkek toplam 72 olgu dahil
edildi. Tanı sonrası takip süresi medyan 88 (20-207) ay, toplam sağ kalım ise
medyan 92,5 (21-207) ay idi. Halen takipte olan 68 olgunun 65 (%95,6)’inin
majör moleküler yanıt ile ve 3 (%4,4) olgunun ise tam sitogenetik yanıt ile
takip edildiği gözlendi.

Sonuç: Kronik faz KML olgularında
prognoz, son 20 yılda TKİ’lerinin klinik pratiğe girmesiyle dramatik bir
şekilde iyileşmiştir ve yaşam beklentisi genel sağlıklı popülasyona
yaklaşmıştır. KML hastalarının günlük pratik izleminde, kılavuzlarda ki
önerilere azami düzeyde uyulmalıdır.

Keywords

myeloid lösemi, kronik, kronik faz

LONG TERM TREATMENT RESULTS OF TARGETED THERAPY IN CHRONIC PHASE CHRONIC MYELOID LEUKEMIA: SINGLE CENTER EXPERIENCE

Abstract

Purpose: Chronic myeloid leukemia (CML)
is a hematopoietic stem cell disease characterized by excessive and
uncontrolled proliferation in myeloid cells. Treatment success in CML has been
significantly increased with tyrosine kinase inhibitors (TKIs). In the
long-term follow-up of CML patients, side-effect management of targeted
therapy, loss of response and close monitoring of drug resistance mechanisms
have gained importance in clinical practice. The aim of this study was to evaluate
the clinical course of chronic phase CML patients who were treated and followed
up in our center, retrospectively.

Material and Method: The results of 72 chronic phase
CML patients treated with TKIs between June 2001 and December 2016 were
evaluated retrospectively.

Results: Seventy-two patients (36 (50%)
female and 36 (50%) male) with a median age of 40 years (16-66) were included
in the study. The median follow-up period was 88 (20-207) months and the median
overall survival was 92.5 (21-207) months. Sixty-five (95.6%) of 68 patients
who were still under follow-up had major molecular response and 3 (4.4%) had
complete cytogenetic response.

Conclusion: The prognosis of chronic phase
CML patients has improved dramatically in the last 20 years with the introduction
of TKIs into clinical practice, and life expectancy has approached the general
healthy population. In the daily practical follow-up of CML patients, the
recommendations in the guidelines should be strictly followed.

Keywords

myeloid leukemia, chronic, chronic phase

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