Imatinib Mesylate Effectiveness in Chronic Myeloid Leukemia with Additional Cytogenetic Abnormalities at Diagnosis among Black Africans

Abstract

Imatinib mesylate provides good results in the treatment of CML in general. But what about the results of this treatment in CML associated with additional cytogenetic abnormalities at diagnosis among black Africans? For this, we retrospectively studied 27 cases of CML associated with additional cytogenetic abnormalities, diagnosed in the department of clinical hematology of the University Hospital of Yopougon in Côte d'Ivoire, from May 2005 to October 2011. The age of patients ranged from 13 to 68 years, with a mean age of 38 years and a sex ratio of 2. Patients were severely symptomatic with a high Sokal score of 67%. CML in chronic phase accounted for 67%. The prevalence of additional cytogenetic abnormalities was 29.7%. There were variants of the Philadelphia chromosome (18.5%), trisomy 8 (14.8%), complex cytogenetic abnormalities (18.5%), second Philadelphia chromosome (14.8%), and minor cytogenetic abnormalities (44.4%). Complete hematologic remission was achieved in 59%, with 52% of major cytogenetic remission. The outcome was fatal in 37% of patients. Death was related in 40% to hematologic toxicity and in 30% to acutisation. The median survival was 40 months.

Untitled

“…Also, the study of Oyekunle et al, 29 , showed that the clinical phase of the disease at diagnosis and the hematocrit can be used to stratify patients into low, intermediate, and high risk groups, with significantly different survival outcomes in Nigerian patients with CML. Aissata et al, 17 , reported that CML patients were severely symptomatic with a performance status ≥2 in 100%, splenomegaly in 100%, fever in 74%, hepatomegaly in 48%, bone pains in 48% and lymphadenopathy in 22%. Splenomegaly was relatively large, ≥10cm in 74%, probably due to the long period of consultation.…”

“…16 Imatinib mesylate provides good results in the treatment of CML in general. 17 Imatinib mesylate, a selective inhibitor of BCR-ABL kinase activity, selectively inhibits downstream signaling and the growth of BCR-ABL+ cells, inducing apoptosis of these cells. 2,18 The development of the BCR-ABL-targeted Imatinib mesylate represents a paradigm shift in the treatment of CML.…”