REAL LIFE DATA OF CHRONIC MYELOID LEUKEMIA PATIENTS IN ISPARTA

Year 2023, , 602 - 609, 30.12.2023

Murat Ardoğan , Demircan Özbalcı , Emine Güçhan Alanoğlu

https://doi.org/10.17343/sdutfd.1266338

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.

Keywords

Charlson comorbidity index, Charlson comorbidity-age index, Chronic Myeloid Leukemia, Real life data, Prognosis

Project Number

Yok

ISPARTA’DAKİ KRONİK MYELOİD LÖSEMİ HASTALARININ GERÇEK YAŞAM VERİLERİ

Abstract

Amaç
Kronik myeloid lösemi (KML), 100.000 yetişkinde 1-2
vaka insidansı olan myeloproliferatif bir neoplazmdır.
KML' nin patogenezinin merkezi, kromozom 9 üzerindeki
Abelson murin lösemi (ABL1) geni ile, kromozom
22 üzerindeki kırılma noktası bölgesi (BCR) geninin
füzyonudur. KML tedavisi, tirozin kinaz inhibitörlerinin
(TKİ) bulunması ile değişmiştir. Bu hedeflenmiş yaklaşım,
KML' nin doğal seyrini değiştirmiş ve 10 yıllık sağ
kalım oranını yaklaşık %80-90’lara çıkarmıştır. TKİ ile
tedavi altında olan “gerçek hayat” KML hastalarımızda
etkin tedavi yönetiminin yapılıp yapılmadığı, tedavi
yanıt oranları ve sağ kalım verilerinin güncel literatür
ile benzer olup olmadığının araştırılması amaçlanmıştır.
Gereç ve Yöntem
Süleyman Demirel Üniversitesi Tıp Fakültesi Hematoloji
Bilim Dalı’nda 2000-2018 yılları arasında KML tanısı
alan 58 KML hastası çalışmaya alınmıştır. Bu çalışmada
hastaların klinik, laboratuvar ve demografik
özellikleri, tedavi seçenekleri, yan etkileri ve yanıtları
değerlendirildi. Sokal, Hasford ve Eutos risk puanlama
sistemi ve Dünya Sağlık Örgütü kriterleri ile risk
değerlendirmesi ve evrelemesi uygulandı. European
Leukemia Network’ün kriterlerine göre hematolojik,
sitogenetik ve moleküler yanıtı belirledik.
Bulgular
Çalışmamızda literatürle benzer yaş ortalaması, erkek/
kadın oranı saptandı. Çalışmamızda yaş dağılımının
(p=0,001) Charlson komorbidite İndeksi’ nin
(p=0,005) ve Charlson komorbidite-yaş İndeksi’ nin
(p=0,000) genel sağkalıma istatistiksel olarak anlamlı
etki ettiği görülmüştür. Çalışmamızda yaş dağılımının
(p = 0.029), Charlson komorbidite yaş İndeksi (p =
0,001) ve 12. ayda Major Moleküler Yanıt (MMY) alınmasının
(p = 0,028) hastalıksız sağkalıma istatistiksel
olarak anlamlı etki ettiği görülmüştür. Çalışmamızda
sadece 12. Ayda MMY (p=0,006) progresyonsuz
sağkalıma istatistiksel olarak anlamlı etki ettiği görülmüştür.
Hastalarda retiküler lif derecesinin genel sağkalım,
hastalıksız sağkalım ve progresyonsuz sağkalıma
önemli ölçüde etki etmediği saptanmıştır.
Sonuç
Bu sonuçlar, KML'nin genellikle mevcut tedavilerle iyi
yönetildiğini ve ölümlerin diğer tıbbi problemler nedeniyle
daha sık meydana geldiğini göstermektedir.
KML’de, Charlson indekslerinin genel sağ kalım ve
hastalıksız sağ kalımla anlamlı derecede ilişkili olduğu
gösterilmiştir.

Keywords

Charlson komorbidite indeksi, Charlson komorbidite-yaş indeksi, Gerçek yaşam verileri, Kronik Myeloid Lösemi, Prognoz

Supporting Institution

Yok

Project Number

Yok

Thanks

YOk

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