Determinants of Overall and Progression-Free Survival of Nigerian Patients with Philadelphia-Positive Chronic Myeloid Leukemia

Abstract

Objective. The tyrosine kinase inhibitors have markedly changed the disease course for patients with Ph+ and/or BCR-ABL1 + chronic myeloid leukemia (CML). This study was embarked upon to assess the long-term effects of imatinib therapy on survival in adult Nigerian patients with CML. Methods. All adult patients on imatinib (400–600 mg) seen from July 2003 to December 2010 were assessed. Male/female distribution was 171/101, with a median age of 38 (range, 20–75) years. Overall survival (OS) and progression-free survival (PFS) were determined using the Kaplan-Meier techniques. Results. Of all the 272 patients, 205 were in chronic phase, 54 in accelerated phase, and five in blastic phase, at commencement of imatinib. As at December 2010, 222 were alive. OS at 1 and 5 years was 94% and 63%, while PFS was 89% and 54%, respectively. Similarly, amongst the 205 patients in chronic phase, OS at 1 and 5 years was 97% and 68%, while PFS was 92% and 57%. Conclusion. Imatinib's place as first-line therapy in the treatment of CML has further been reinforced in our patients, with improved survival and reduced morbidity, comparable with outcomes in other populations.

Chronic Myeloid Leukemia in Nigerian Patients: Anemia is an Independent Predictor of Overall Survival

“…This has consistently been established in previous studies and in all reports from our cohort, including this study. 15,19 In contrast to what has been reported from other CML studies including our earlier reports, this study has established that anemia at diagnosis is an independent prognostic factor predicting the poor OS. Indeed, the recent study by Saußele et al, 20 in which 1519 German CML patients were retrospectively studied for the impact of comorbidities on survival outcomes, found that OS was affected more by comorbidities than by CML and that hemoglobin level had no significant influence.…”

“…The median age of 37 years is similar to what we had reported in our earlier studies comprising fewer of these patients, 36 years in 2008 ( n = 98) and 38 years in 2015 ( n = 272), 14,15 and what has been reported from Ivory Coast but differs significantly from populations in the Western world. 17,18 Similar to incidence, it is equally unclear whether these are mere reflections of the younger population distribution as found in most developing countries or a true difference in CML biology.…”

“…Similarly, the five-year OS has increased from 63% ( n = 272) to 75% in the current analysis. 14,15 It is to be noted that since this study has a much longer follow-up period and more patients, the survival outcomes are more reliable.…”

“…Clinical and hematological parameters collected are as previously reported. 14,15 Data collection, cleaning, and validation were done in MS Excel, while statistical analysis was done using SPSS version 22 (IBM SPSS Statistics, 2013). Survival analysis was done using the Kaplan-Meier techniques, using definitions as previously reported in Refs.…”

Prognostic impact of Additional Chromosomal Abnormalities in Egyptian Chronic Myeloid Leukemia Patients

“…Mechanisms of resistance to TKIs in CML include genomic amplifications, point mutations of the ABL tyrosine kinase domain, and emergence of ACAs [15]. The median age of patients at diagnosis was 37 years which is comparable to previous studies in Pakistan, Nigeria, Mexico [16], [17], [18], and previous Egyptian reports [19], [20]. In our study, we found that patients <40 years tended to develop ACAs more than patients ≥40 years (55% vs. 30%), respectively (p = 0.034).…”