Introduction: Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder; the molecular hallmark of the disease is the BCR-ABL gene rearrangement, which usually occurs as the result of a reciprocal translocation between chromosomes 9 and 22. Tyrosine kinase inhibitors (TKI) were the first drugs that targeted the constitutively active BCR-ABL kinase and it have become the standard frontline therapy for CML. Monitoring the treatment of CML patients with detection of bcr-abl transcript levels with real time qualitative polymerase chain reaction (RQ-PCR) is essential in evaluating the therapeutic response. Material and method: At the Clinical Hematology and BMT Unit Tîrgu Mureș, between 2008-2011, we performed the molecular monitoring of bcr-abl transcript levels with RQ-PCR in 16 patients diagnosed with CML. Results: We have 11 patients on imatinib treatment who achieved major molecular response. One patient lost the complete molecular response after 5 years of treatment. Two patients in blast crisis underwent allogeneic hematopoietic stem cell transplantation from identical sibling donors. The first patient is in complete molecular remission after 4 years of the transplant with mild chronic GVHD. The other patient had an early relapse with treatment refractory disease and died from evolution of the disease. Three patients with advanced phases of the disease present increasing transcript levels. We performed the dose escalation, and for two of them the switch to the second generation of TKI. Conclusions: Regular molecular monitoring of individual patients with CML is clearly desirable. It allows for a reassessment of the therapeutic strategy in cases of rising levels of BCR-ABL as an early indication of loss of response.

Introduction and aim: Chronic myeloid leukemia is a clonal myeloproliferative disorder characterized by the BCR-ABL gene rearrangement with translocation between chromosomes 9 and 22. The constitutively active BCR-ABL tyrosine kinase inhibitor became the standard frontline therapy. The molecular monitoring is essential. Method: We studied the chronic myeloid leukemia patients at the Clinical Hematology and Bone Marrow Transplant Unit Tg-Mures between 2008 and 2018. Results: We followed 59 patients, median age of 45 years, female : male ratio 1.5 : 1. 80% of the patients were in chronic phase. Sokal score was low in 61%, intermediate 27% and high in 12% of the patients. The median follow-up time was 5 years and 9 months. 59% of the patients reached molecular remission (average time 11 months). The cumulative overall survival was 80% at 5 years and 76% at 10 years. The overall survival according to disease phase was 98%, 85%, 20%; according to Sokal score it was 91%, 66%, 51%. The cumulative progression-free survival was 75% at 5 years and 50% at 10 years. Only 8% of the low risk patients are progressing opposite to 77% of the high risk patients. The cumulative probability to maintain the molecular remission for 5 years is 100%, for 10 years 91% and for 15 years 52%. Conclusion: A rising level of BCR-ABL is an early indication of the loss of response identifying the patients who need close monitoring and therapeutic change. Orv Hetil. 2019; 160(2): 67–72.

Introduction: Anemia is a common complication of malignant lymphomas, which could be a direct consequence of the disease or secondary to the myelosupressive chemotherapy. The aim of this study was to assess the effect of erythropoietin to treat anemia. The main objectives were to demonstrate increases in hemoglobin levels and the existence of an association between symptom relief and treatment. Material and method: In the Clinical Hematology and BMT Unit Tîrgu Mureș we performed an analytical, observational study to assess the role of erythropoietin treatment in malignant lymphoma related anemia. This linear, retrospective study included 127 patients diagnosed and treated with malignant lymphoma between January 1 st , 2007 and December 30, 2011. The 127 patients were divided into two groups: a group of patients (n = 88) who were treated with erythropoietin and the other group (n = 39) who did not receive this treatment. Patients included in the study received treatment with epoetin beta 40,000 IU/week. We followed the hemoglobin level and the symptomatology at baseline and after 4 weeks. Results: Patients who received treatment with erythropoietin had a 7.12 times higher possibility of being asymptomatic than patients who did not receive this treatment. The hemoglobin concentration of patients with erythropoietin treatment increased signifi cantly (p <0.0001) compared to the patients who did not receive this treatment. Conclusion: Effective treatment of anemia is an important aim in the management of patients with malignant lymphomas, because it increases their hemoglobin concentration, decreases the need of transfusion and maintains an acceptable quality of life.