MANAGEMENT OF PATIENTS WITH CHRONIC MYELOID LEUKEMIA – AN ACTUAL ISSUE OF ONCOLOGY AND PUBLIC HEALTH

Abstract

Objectives: The aims of the study were to identify and evaluate the epidemiological aspects and management options in chronic myeloid leukemia (CML). Methods: We performed the analytical, cohort and prospective-retrospective study of 134 patients with CML, who were treated and followed up in the Institute of Oncology from Moldova between 2005–2021. The quantitative reverse transcription polymerase chain reaction (RT-PCR) was accomplished in order to determine the expression of the BCR-ABL p210 and p190 transcripts. Tyrosine kinase inhibitors (TKIs) were used as a front-line therapy in the newly diagnosed CML patients and in the cases of resistance to non-TKIs chemotherapy and interferon-?. Results: The diagnosis of CML was established in chronic phase in 122 (91,04 ± 2,32%) patients, in the accelerated and acute phases – in 12 (8,96 ± 2,03%). BCR-ABL p210 transcript range was 21.84–100% IS. Under the first-line TKIs therapy, the complete molecular response was obtained in 24.3% of cases. No significant differences were registered in the rate of complete hematologic response (92.3% vs 92.8%) and complete molecular response (23.8% vs 24.7%) under the TKIs medication between the elderly patients and the whole cohort of CML patients. The overall one- and 5-year survival in elderly patients treated with TKI was 97.6 and 79%, being comparable with the respective parameters in the totality of CML patients (98.5% and 87%, correspondingly). Conclusions: The treatment with TKIs remains a curative option of choice for CML patients regardless of the age, gender and CML phase.