Chronic myeloid leukemia (CML), is one of the myeloproliferative disorders with a characteristic cytogenetic abnormality resulting in the BCR-ABL fusion gene. Imatinib Mesylate is an effective agent for treating patients in all stages of CML. According to the annual Iraqi cancer registry 2019, the total number of chronic myeloproliferative disorders was 338. The percentage and incidence rates were 0.94% and 0.86%, respectively, with a higher incidence rate in males than females (1.12 in males and 0.60 in females). In this registry, no details about CML, so this study aimed to estimate the number of CML patients who attended the national center of hematology from 2005 until 2020 and investigate their epidemiological and clinic-pathological data. All data were obtained from the National Center of Hematology /Baghdad. Data regarding annual admission, number of deaths, and information about age, regions, and sex, were collected from patient cards. Interview and history taking from the patient and reviewing their clinical features at diagnosis were performed, and then statistical analysis was achieved. Two hundred sixteen patients were registered as CML; among them, 163 are still alive, while 53 died. The mean age at diagnosis was 40.39 ±14.30, with a male-to-female ratio of 1:1.16. The pediatrics age group comprises 3.7% of total cases and 1.8 % and 9.4% in the alive and dead groups, respectively. The percentages of death were higher in the pediatric age group, 62,5%( 5 /8), followed by the patient group who were ≥60 years, 42.1%(8/19), while it was the least in adults < 60 years, 21.1% (40/189). In conclusion, the studied patients with CML were younger than the globally reported ages at diagnosis, with predominant female patients. Females had better survival, while children and the elderly were the worse. Most patients were symptomatic at diagnosis; however, a good outcome is achieved when treated with IM. Keywords: CML, Imatinib, leukemia,

Imatinib Mesylate is an oral chemotherapy drug that has been used to treat Chronic Myelogenous Leukemia (CML). It works as an inhibitor of oncogene tyrosine kinase BCR-ABLI as a target therapeutic agent. Despite the drug is well tolerated in most patients, impaired testosterone production and Gynecomastia after therapy might happen. The current study aims to evaluate the impact of Imatinib Mesylate on sex hormones of CML male patients in Baghdad province. Blood specimens were collected from (42) CML patients aged 23 to 68 years who used Imatinib drug for more than two years, and (45) normal persons aged 25 to 65 years as a control group. Exclusion criteria were performed for both control and CML patient's groups, including people with diabetes, hypertensive, and males complaining of infertility after taking medical history for every participant. The blood level of hemoglobin (Hb), white blood cells (WBC), platelet count, testosterone, LH, and FSH were evaluated and investigated. The obtained results showed a significantly lower level of testosterone (2.73+- 0.97) ng/mL than the control group (4.72 ±1.02) ng/mL with a p-value of 0.000. While LH (4.53±2.1) mIU/mL and FSH (5.12 ± 2.83) mIU/mL were significantly higher than the control group (3.77± 0.8) mIU/mL and (3.85±0.807) mIU/mL with p-value of 0.026 and 0.005 respectively. Moreover, the outcomes revealed a moderate positive correlation (r = +0.348) between LH hormone levels with a duration increasing time of using Imatinib, while platelet showed a moderate negative correlation (r = -0.321) with time-consuming using that drug. In conclusion, Imatinib might harm testis functions and some hematological parameters that could increase using this drug.

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Background: Chronic myeloid leukemia (CML) is myeloproliferative of hematopoietic stem cells resulting in marked increased in granulocytes, platelets and red cells. Imatinib mesylate (IM) is potent tyrosine kinase inhibitor acts by occupying ATP binding site for BCR-ABL oncoprotein preventing phosphorylation of substrate and interrupting contact with protein. Aim of study: Evaluation of thyroid function and myelosuppresion induced by IM in CML patients. Materials and Methods: The study enrolled 13 patients with CML treated by IM for more than 6 months. Total blood count and blood film and thyroid function. Tests (T1 ,T4 and TSH) were performed. Results: All patients belong to Grade3 and Grade2 only of mylosuppresion, the most common cytopenia is neutropenia in (7) patients, anemia in (5) patients and only (4)patients having thrombocytopenia. Only three patients don’t achieve remission (6.6 %).Regarding thyroid function only one patient has high TSH level with normal T1 and T4. In spite of TSH level in patients significantly higher than the control group the mean values of two group were within normal range. Non-significant difference in T1 and T4 between the control and patients groups. Conclusion: IM do not seem to has clinically significant effect on thyroid function. However, thyroid function test is indicated before initiated of treatment with IM. Also CBC is highly recommended for monitoring CML patients on IM.

Cancer is regarded as global burden and a serious health challenge. Its occurrences increased due to population aging and the prevalence of risk factors. This study investigated the eff ect of metformin and aspirin on two cell lines SR (diff use large B cell lymphoma) and NB4 (promyelocytic leukemia). The eff ect of metformin as monotherapy on SR was 28.43% viable, while on NB4, only 44.4% were viable. However, the eff ect of aspirin on SR and NB4 cell lines were decreased; the percentage of cell viability were 27.2 and 41.2%, respectively. In conclusion, there is signifi cant eff ect of metformin and aspirin on SR cell line and only mild eff ect on NB4. These may be useful drugs in old diabetic patients with diff use large B cell lymphoma that may reduce the chemotherapy dose