Pérez-Zúñiga JM, Vicenteño-Luna FJ, Reséndiz-Olea R, Martínez-Ríos A, García-Sánchez R

Language: Spanish
References: 21
Page: 696-702
PDF size: 446.13 Kb.

ABSTRACT

Background: Chronic myeloid leukemia is a myeloproliferative disease; the most effective drugs in the treatment of this disease are imatinib, nilotinib and dasatinib. Those drugs are available at the ISSSTE.
Objectives: To know the number of chronic myeloid leukemia cases, to identify the clinical characteristics and to measure the degree of response to tyrosine kinase inhibitors and the survival.
Material and Method: A retrospective, cross-sectional, observational and explanatory study was done from 2005 to 2016, including patients over 18 years of age, with a diagnosis of chronic myeloid leukemia; with any of the three phases of the disease and treatment with any of the tyrosine kinase inhibitors.
Results: There were included 31 cases (55.2% women); the median age was 62 years; 72.4% were in chronic phase, 27.6% in accelerated phase and none in the blast phase. The haematological response was of 94.1%, 90% and 96%; the complete cytogenetic response at 12 months was of 69.2%, 60% and 57% and the mayor molecular response was of 62.9%, 68.6%, 69.1% of the patients treated with imatinib, nilotinib or dasatinib, respectively. Disease-free survival at 5 years was of 83% and global survival at 5 years was of 94%.
Conclusion: Independently of the inhibitor prescribed, the hematologic response is achieved in more than 90%, the complete cytogenetics around 60% at 12 months and major molecular almost 60% in a ISSSTE hospital.

REFERENCES

1. Frazer R, Irvine AE, McMullin MF. Chronic myeloid leukaemia in the 21st century. Ulster Med Journal 2007.

2. Jabbour E, Kantarjian H. Chronic myeloid leukemia: 2016 update on diagnosis, therapy, and monitoring. Am J Hematol 2016;91(2):252-265. https://doi.org/10.1002/ajh.24275

3. Rohrbacher M, Hasford J. Epidemiology of chronic myeloid leukaemia (CML). Best Practice and Research: Clinical Haematology 2009;22(3):295-302. https://doi.org/10.1016/j. beha.2009.07.007

4. Höglund M, Sandin F, Simonsson B. Epidemiology of chronic myeloid leukaemia: an update. Ann Hematol 2015. https:// doi.org/10.1007/s00277-015-2314-2

5. Chávez-González MA, Ayala-Sánchez M, Mayani H. La leucemia mieloide crónica en el siglo XXI: biología y tratamiento. Revista de Investigación Clinica 2009;61(3):221– 232. Retrieved from http://www.medigraphic.com/pdfs/ revinvcli/nn-2009/nn093f.pdf

6. Goldman JM. Chronic myeloid leukemia: A historical perspective. Sem Hematol 2010;47(4):302-311. https://doi. org/10.1053/j.seminhematol.2010.07.001

7. Innes AJ, Milojkovic D, Apperley JF. Allogeneic transplantation for CML in the TKI era: Striking the right balance. Nature Reviews Clinical Oncology 2016. https://doi. org/10.1038/nrclinonc.2015.193

8. Grigg A, Hughes T. Role of allogeneic stem cell transplantation for adult chronic myeloid leukemia in the imatinib era. Biology of Blood and Marrow Transplantation. J Am Soc Blood Marrow Transplant 2006;12(8):795-807. https:// doi.org/10.1016/j.bbmt.2006.03.012

9. Cortes JE, Talpaz M, Kantarjian H. Chronic myelogenous leukemia: a review. Am J Medicine 1996;100(5):555-570. https://doi.org/10.1016/S0002-9343(96)00061-7

10. Baran Y, Saydam G. Cumulative clinical experience from a decade of use: imatinib as first-line treatment of chronic myeloid leukemia. J Blood Med 2012;3:139-50. https:// doi.org/10.2147/JBM.S29132

11. Druker BJ, Talpaz M, Resta DJ, Peng B, Buchdunger E, Ford JM, Sawyers CL. Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. N Engl J Med 2001;344(14):1031–7. https://doi.org/10.1056/ NEJM200104053441401

12. O’Brien SG, Guilhot F, Larson RA, Gathmann I, Baccarani M, Cervantes F, Druker BJ. Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med 2003;348(11):994- 1004. https://doi.org/10.1056/NEJMoa022457

13. Weisberg E, Manley P, Mestan J, Cowan-Jacob S, Ray A, Griffin JD. AMN107 (nilotinib): A novel and selective inhibitor of BCR-ABL. Br J Cancer 2006. https://doi.org/10.1038/ sj.bjc.6603170

14. Saglio G, Kim DW, Issaragrisil S, le Coutre P, Etienne G, Lobo C, Kantarjian HM. Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia. N Engl J Med 2010;362(24):2251-2259. https://doi.org/10.1056/ NEJMoa0912614

15. Kantarjian H, Shah NP, Hochhaus A, Cortes J, Shah S, Ayala M, Baccarani M. Dasatinib versus Imatinib in newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Medicine 2010;362(24):2260-2270. https://doi. org/10.1056/NEJMoa1002315

16. Pophali PA, Patnaik MM. The role of new tyrosine kinase inhibitors in chronic myeloid leukemia. Cancer J (Sudbury, Mass) 2016;22(1):40-50. https://doi.org/10.1097/ PPO.0000000000000165

17. Goldman JM. How I treat chronic myeloid leukemia in the imatinib era. Blood 2007;110(8): 2828–2837. https://doi. org/10.1182/blood-2007-04-038943

18. Von Bubnoff N. Prognostic significance of treatment response in CML in view of current recommendations for treatment and monitoring. Ther Adv Hematol 2011. https://doi.org/10.1177/2040620711402415

19. Ayala M, Ávila E, Domínguez J, Aquino X, Vela J. Diagnosis and treatment of chronic myeloid leukemia in the imatinib mesylate era: report of the experience at “La Raza” Medical Center in Mexico. Clinical Lymphoma, Myeloma and Leukemia 2016. https://doi.org/10.1016/j. clml.2015.10.006

20. Cross NCP, White HE, Müller MC, Saglio G, Hochhaus A. Standardized definitions of molecular response in chronic myeloid leukemia. Leukemia 2012;26(10):2172–2175. https://doi.org/10.1038/leu.2012.104

21. Mahon FX, Etienne G. Deep molecular response in chronic myeloid leukemia: The new goal of therapy? Clinical Cancer Research 2014. https://doi.org/10.1158/1078-0432. CCR-13-1988