Treatment results of chronic myeloid leukemia patients in HOK Olomouc during 2000–2009: the prognostic significance of Sokalęs score and ELN criterions
Authors:
P. Rohoň 1; Š. Rožmanová 1; J. Zapletalová 2; I. Skoumalová 1; M. Divoká 1; M. Holzerová 1; K. Indrák 1; E. Faber 1
Authors‘ workplace:
Hemato-onkologická klinika FN a LF UP v Olomouci, 2Ústav lékařské biofyziky LF UP v Olomouci
1
Published in:
Transfuze Hematol. dnes,16, 2010, No. 4, p. 202-209.
Category:
Comprehensive Reports, Original Papers, Case Reports
Overview
Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of hematopoietic stem cell with myeloid differentiation predominantly. Now, in the age of imatinib (IM) and new tyrosine kinase inhibitors (TKI), the prognosis and quality of patients life improved rapidly. In our work, we analyzed 110 adult patients with CML in chronic phase who received IM or 2nd generation TKI in the years 2000–2009. 40 patients (36,4 %) started treatment with IM in the 1st line and 70 (63,6%) were previously treated with interferon-α (IFN-α) (IM in the 2nd line). In 104 (94,5 %) patients the long-term survival (OS) was observed, 6-years probability of OS is 94.0 %. Comparing IM in the 1st and 2nd line treatment, we can conclude that complete cytogenetic response was achieved in 87,5 % vs. 80,0 % of patients in a median 7 vs. 15 months (p = 0,02), major molecular response in 67,5 % vs. 41,4 % of patients in a median 16 vs. 17 months (p = 0,34) and complete molecular response in 32,5% vs. 40.0 % of patients in a median 24 vs. 24 months (p = 0.42). Treatment results with IM in the 1st line correlate with literature data. Adjusted OS with IM in the 2nd line after IFN-α after 6 years is 95.4 % and belongs to the best reported in the literature. Sokalęs score shows an excellent correlation with the OS. Independent prognostic factor for OS, PFS and EFS are ELN criteria. Cytogenetic and molecular progression during IM treatment occurred in 27 patients (24,5 %) and in 9 cases (8,2 %) mutations in the BCR-ABL kinase domain were detected. 2 patients from the subgroup with mutations showed complex karyotype; in one case also trisomy of chromosome 8 appeared in Ph negative clone. Our experience demonstrates the high efficiency of IM in the 1st and 2nd lines in the routine clinical practice.
Key words:
chronic myeloid leukemia, imatinib, resistance
Sources
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