Improved clinical practice and updated management in chronic myeloid leukemia

Abstract

Chronic myeloid leukemia (CML) is a clonal myeloproliferative tumor of hematopoietic system resulting from the stem cell malignant transformation, with maintenance of ability of differentiation of all cell lineages. The study enrolled 125 patients with different phases of CML and age range of 19 - 81 years old (median age - 46.1 ± 2.13 years), who had been treated and followed up at the MSPI Institute of Oncology in 2005 - 2013. The combined screening for Ph chromosome and BCR-ABL p210 and p190 chimeric gene transcripts is mandatory for diagnosis in patients fairly suspected for chronic myelogenous leukemia, as well as for the proper evaluation of the response to treatment. The discriminant analysis revealed the higher coeffi cients of canonical correlation for the following late diagnosis factors: asymptomatic or oligosimptomatic onset of the disease (0.548), low level of the sanitary education of population (0.525) and the onset with indiscrete clinical and paraneoplastic symptoms (0.340). Imatinib mesylate and dasatinib constitute the fi rst-line therapeutic option in the chronic and accelerated phases of CML, being superior to conventional chemotherapy and interferon-α due to the possibility of the achievement of the complete hematologic response, complete cytogenetic response and the improvement of the patients life quality. The overall 3-year survival rate in patients approved for GIPAP (66.0%) was superior (p