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Kronik Miyeloid Lösemide İmatinib Mesilat Tedavisi

Yıl 2020, , 107 - 112, 16.03.2020
https://doi.org/10.31832/smj.648445

Öz

Amaç: Merkezimizde
takip edilen ve imatinib tedavisi alan kronik miyeloid lösemi (KML)
hastalarında tedavinin etkinliğini retrospektif olarak değerlendirmek.

Gereç ve Yöntem: Çalışmaya klinik ve laboratuvar verileri tam olan 85
kronik evre KML hastası dahil edildi. Bu hastalar, interferon tedavisi sonrası hematolojik
veya sitogenetik yanıt gözlenmeyen veya interferon tedavisine karşı intolerans
gelişmiş veya birinci basamak tedavi olarak imatinib tedavisi almıştır.

Bulgular: Kırk sekiz (% 56,47) hasta erkek, 37 (% 43,53) hasta
kadındı. Tanı sırasındaki hastaların yaşlarının ortancası yaş 52 idi (19-79).
Ortalama takip süresi 45 (12-158) aydı. İzlemde kronik faz hastalarının 6'sı
blastik ve hızlandırılmış faza ilerlemiştir. İmatinib tedavisinin üçüncü
ayında, 77 (% 90,59) hasta tam hematolojik yanıt aldı ve 85 (% 100) hasta 18
ayda tam hematolojik yanıt aldı. Çalışmamızda, uygun metafazlı (≥ 20) 78
hastanın sitogenetik verileri, tanı konulduktan sonraki ilk 18 ay içinde
değerlendirildi. 18 ayın sonunda 78 hastanın 68'inde (% 87.18) tam sitogenetik
yanıt vardı.







Sonuç: İmatinib,
KML hastaları tarafından iyi tolere edilir ve alternatif bir tedavi yöntemidir.

Kaynakça

  • 1. Goldman JM. Chronic myeloid leukemia: a historical perspective. Semin Hematol 2010;47(4):302-11.
  • 2. Pophali PA, Patnaik MM. The role of new tyrosine kinase inhibitors in chronic myeloid leukemia. Cancer J 2016;22(1):40-50.
  • 3. Druker BJ, Tamura S, Buchdunger E, Ohno S, Segal GM, Fanning S, et al. Effects of a selective inhibitor of the Abl tyrosine kinase on the growth of Bcr-Abl positive cells. Nat Med 1996;2(5):561-6.
  • 4. Druker BJ, Talpaz M, Resta DJ, Peng B, Buchdunger E, Ford JM, et al. Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. N Engl J Med 2001;344(14):1031-7.
  • 5. O'Brien SG, Guilhot F, Larson RA, Gathmann I, Baccarani M, Cervantes F, et al. Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med 2003;348(11):994-1004.
  • 6. Hughes TP, Hochhaus A, Branford S, Müller MC, Kaeda JS, Foroni L, et al. Long-term prognostic significance of early molecular response to imatinib in newly diagnosed chronic myeloid leukemia: an analysis from the International Randomized Study of Interferon and STI571 (IRIS). Blood 2010;116(19):3758-65.
  • 7. Goldman JM. Chronic myeloid leukemia- still a few questions. Exp Hematol 2004;32:2-10.
  • 8. Deininger M, O Brien SG, Guilhot F. et al. International randomized study of interferon vs. STI571 (IRIS) 8 year follow up: sustained survival and low risk for progression of events in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP) treated with imatinib.Blood 2009;114.
  • 9. Cervantes F, Hernández-Boluda JC, Steegmann JL, Conde E, Alvarez–Larrán A, López-Jiménez J, et al. Imatinib mesylate therapy of chronic phase chronic myeloid leukemia resistant or intolerant to interferon: results and prognostic factors for response and progression–free survival in 150 patients. Hematologica 2003;88:1117-22.
  • 10. Kantarjian HM, O’Brien S, Cortes J, Giles FJ, Rios MB, Shan J, et al. Imatinib mesylate therapy improves survival in patients with newly diagnosed Philadelphia chromosome-positive chronic myelogenous leukemia in the chronic phase. Cancer 2003;98:2636-42.
  • 11. Goldman JM, Marin D, Olavarria E, Apperley JF. Clinical decisions for chronic myeloid leukemia in the imatinib era. Semin Hematol 2003;40:98-103.
  • 12. Gratwohl A. The EBMT risk score. Bone Marrow Transplant 2012;47(6):749-756.
  • 13. Saussele S, Lauseker M, Gratwohl A et al. German CML Study Group. Allogeneic hematopoietic stem cell transplantation (allo SCT) for chronic myeloid leukemia in the imatinib area:evalution of its impact within subgroup of the randomized German CML Study IV. Blood 2010;115(10):1880-1885.

Imatinib Mesylate Treatment in Chronic Myeloid Leukemia

Yıl 2020, , 107 - 112, 16.03.2020
https://doi.org/10.31832/smj.648445

Öz

Objective: To evaluate retrospectively the efficacy of treatment
in chronic myeloid leukemia (CML) patients followed up in our center and
receiving imatinib treatment.

Materials and Methods: Eighty-five chronic phase CML patients with adequate
clinical and laboratory data were included in the study. These patients had not
given hematological or cytogenetic responses after interferon treatment, or had
intolerance to IFN treatment or received imatinib treatment as a first-line
treatment in late and early chronic stage patients.

Results: Forty-eight (56.5%)
patients were male and 37 (43.5%) of them were female. The median age at
diagnosis was 52 years (19-79). The mean follow-up period was 45 (12-158)
months. In the follow-up, 6 of the chronic phase patients progressed to blastic
and accelerated phase. In the third month of imatinib treatment, 77 (90.6%)
patients had complete hematologic response and 85 (100%) patients had full
hematologic response at 18 months. In our study, cytogenetic data of 78
patients with adequate metaphase (≥ 20) could be evaluated within the first 18
months after the diagnosis was made. At the end of 18 months, 68 (87.2%) of 78
patients had complete cytogenetic response.







Conclusion: Imatinib is well tolerated by CML patients and is a
superior treatment alternative to other therapies other than bone marrow
transplantation in achieving hematological and cytogenetic response.

Kaynakça

  • 1. Goldman JM. Chronic myeloid leukemia: a historical perspective. Semin Hematol 2010;47(4):302-11.
  • 2. Pophali PA, Patnaik MM. The role of new tyrosine kinase inhibitors in chronic myeloid leukemia. Cancer J 2016;22(1):40-50.
  • 3. Druker BJ, Tamura S, Buchdunger E, Ohno S, Segal GM, Fanning S, et al. Effects of a selective inhibitor of the Abl tyrosine kinase on the growth of Bcr-Abl positive cells. Nat Med 1996;2(5):561-6.
  • 4. Druker BJ, Talpaz M, Resta DJ, Peng B, Buchdunger E, Ford JM, et al. Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. N Engl J Med 2001;344(14):1031-7.
  • 5. O'Brien SG, Guilhot F, Larson RA, Gathmann I, Baccarani M, Cervantes F, et al. Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med 2003;348(11):994-1004.
  • 6. Hughes TP, Hochhaus A, Branford S, Müller MC, Kaeda JS, Foroni L, et al. Long-term prognostic significance of early molecular response to imatinib in newly diagnosed chronic myeloid leukemia: an analysis from the International Randomized Study of Interferon and STI571 (IRIS). Blood 2010;116(19):3758-65.
  • 7. Goldman JM. Chronic myeloid leukemia- still a few questions. Exp Hematol 2004;32:2-10.
  • 8. Deininger M, O Brien SG, Guilhot F. et al. International randomized study of interferon vs. STI571 (IRIS) 8 year follow up: sustained survival and low risk for progression of events in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP) treated with imatinib.Blood 2009;114.
  • 9. Cervantes F, Hernández-Boluda JC, Steegmann JL, Conde E, Alvarez–Larrán A, López-Jiménez J, et al. Imatinib mesylate therapy of chronic phase chronic myeloid leukemia resistant or intolerant to interferon: results and prognostic factors for response and progression–free survival in 150 patients. Hematologica 2003;88:1117-22.
  • 10. Kantarjian HM, O’Brien S, Cortes J, Giles FJ, Rios MB, Shan J, et al. Imatinib mesylate therapy improves survival in patients with newly diagnosed Philadelphia chromosome-positive chronic myelogenous leukemia in the chronic phase. Cancer 2003;98:2636-42.
  • 11. Goldman JM, Marin D, Olavarria E, Apperley JF. Clinical decisions for chronic myeloid leukemia in the imatinib era. Semin Hematol 2003;40:98-103.
  • 12. Gratwohl A. The EBMT risk score. Bone Marrow Transplant 2012;47(6):749-756.
  • 13. Saussele S, Lauseker M, Gratwohl A et al. German CML Study Group. Allogeneic hematopoietic stem cell transplantation (allo SCT) for chronic myeloid leukemia in the imatinib area:evalution of its impact within subgroup of the randomized German CML Study IV. Blood 2010;115(10):1880-1885.
Toplam 13 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Demet Çekdemir 0000-0002-1881-5166

Mehmet Gunduz 0000-0001-9105-6429

Yayımlanma Tarihi 16 Mart 2020
Gönderilme Tarihi 19 Kasım 2019
Yayımlandığı Sayı Yıl 2020

Kaynak Göster

AMA Çekdemir D, Gunduz M. Imatinib Mesylate Treatment in Chronic Myeloid Leukemia. Sakarya Tıp Dergisi. Mart 2020;10(1):107-112. doi:10.31832/smj.648445

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