Response to tyrosine kinase inhibitors in chronic myeloid leukemia: experience from a west Asian developing country

Abstract

Tyrosine Kinase inhibitors (TKIs) have dramatically changed the prospects for patients with chronic myeloid leukemia (CML); however, information on CML and response to TKIs from Asia are limited, particularly from West Asia, including Iraq. To address the latter issue we evaluated and monitored a cohort of 108 Iraqi patients diagnosed as chronic phase-CML, enrolled in a government-sponsored national program. The patients were all treated initially by imatinib mesylate. Ninety-two percent of patients had a complete hematological response, 38% had a major molecular response, while 79% had a major cytogenetic response after a median follow-up of 35.7 months. The 3-year Event-Free, Progression-Free, and Overall survival rates were 79.6, 87 and 98.1%, respectively. A total of 26 patients (24.1%) were shifted to an alternative TKI (Nilotinib). After one year of therapy in seventeen of the latter patients, 24% had major molecular response. In conclusion, our results compare favorably with those reported from the West and some Asian countries, and have demonstrated the importance of molecular as well as cytogenetic monitoring, and confirmed the relative success of the national CML program in our country.

Impact of imatinib interruption and duration of prior hydroxyurea on the treatment outcome in patients with chronic myeloid leukemia: Single institution experience

“…In our analysis, the PFS, and the percentage of those who are still receiving imatinib, were inferior to the previously published trials, including some studies in other developing countries [38,39]. These results could be attributed to small number of patients, retrospective nature of the study, and irregular intake of imatinib.…”

Treatment of Chronic Myeloid Leukemia in Rural Rwanda: Promising Early Outcomes

“…Most published studies on CML management and outcomes in LMICs describe programs in private and/or urban academic centers. 9-16 In contrast, our experience is one of the few documented that describes care in a low-income country and serves poor patients in rural areas, with care directed by generalist physicians and nurses. In our cohort, treatment was successful for the majority of patients, with CBC remission exceeding 60% at 3 months of therapy.…”