Assessment of Treatment Outcome in Chronic Myelogenous Leukemia Patients on Tyrosine Kinase Inhibitors: Insight From a Resource Limited Setting

IF 3.1 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2025-02-07 DOI:10.1002/cam4.70635

Wude Yewondwosen Awlachew, Abel Tenaw Tasamma, Firehiwot Abebe Mengistie, Zekarias Tadele Alemineh, Samuel Tesfaye Tefera

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Abstract

Background

Chronic myeloid leukemia (CML) is a hematologic malignancy characterized by the translocation t(9;22)(q34;q11.2), which results in a constitutively active tyrosine kinase. The introduction of tyrosine kinase inhibitors (TKIs) has significantly altered the disease course for patients with BCR-ABL1+ CML globally.

Objective

This study aimed to evaluate the treatment outcomes of CML patients in Ethiopia.

Methodology

This was a single-center, cross-sectional study conducted on 330 patients diagnosed with CML, who were on TKI therapy and receiving follow-up at Tikur Anbessa Specialized Hospital (TASH). Data were collected from electronic medical records using a structured data abstraction tool. Chi-square statistics and binary logistic regression were employed to examine the associations between categorical variables, with statistical significance set at a p value < 0.05. A 95% confidence interval was used.

Results

The median age of patients was 37.0 years (interquartile range [IQR]: 29.0–49.3), and 185 (56.1%) of the patients were male. At diagnosis, 92.1% were in the chronic phase of CML, while 9 (2.7%) were in blast crisis. The complete hematologic response (CHR) rate at 3 months was 90.9% (291/320), while the CHR rate beyond 3 months was 90.2% (258/286). Multivariable logistic regression analysis showed that the likelihood of not achieving a complete/partial hematologic response was higher among those diagnosed in the advanced phase of CML (AOR: 6.114, 95% CI: 2.210, 16.910) and among patients requiring a treatment change (AOR: 5.765, 95% CI: 2.460, 13.512).

Conclusion

The median age of CML patients in our study was notably young. The 3-month and overall hematologic responses were excellent. The initial phase of CML at diagnosis and treatment switch was associated with the 3-month CHR, while only treatment switch was associated with the overall CHR.

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慢性髓性白血病患者酪氨酸激酶抑制剂治疗结果的评估：来自资源有限环境的见解

慢性髓系白血病（Chronic myeloid leukemia， CML）是一种以t(9;22)（q34;q11.2）易位为特征的血液系统恶性肿瘤，其导致酪氨酸激酶组成性活性升高。酪氨酸激酶抑制剂（TKIs）的引入显著改变了全球BCR-ABL1+ CML患者的病程。目的评价埃塞俄比亚CML患者的治疗效果。这是一项单中心、横断面研究，对330名在提库尔安贝萨专科医院（TASH）接受TKI治疗并接受随访的CML患者进行了研究。使用结构化数据抽象工具从电子病历中收集数据。采用卡方统计和二元逻辑回归检验分类变量之间的相关性，p值为<； 0.05。采用95%置信区间。结果患者年龄中位数为37.0岁（四分位数间距[IQR]: 29.0 ~ 49.3），男性185例（56.1%）。诊断时92.1%为慢性粒细胞白血病慢性期，9例（2.7%）为急性危象期。3个月的完全血液学缓解率（CHR）为90.9%(291/320)，3个月以上的完全血液学缓解率为90.2%（258/286）。多变量logistic回归分析显示，在诊断为CML晚期的患者（AOR: 6.114, 95% CI: 2.210, 16.910）和需要改变治疗的患者（AOR: 5.765, 95% CI: 2.460, 13.512）中，未达到完全/部分血液学缓解的可能性更高。结论本研究CML患者的中位年龄明显偏年轻。3个月和总体血液学反应非常好。CML在诊断和治疗切换时的初始阶段与3个月的CHR相关，而只有治疗切换与总CHR相关。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.