Hematology Oncology and Pharmacogenetics Engineering Sciences (HOPES) Group, Health Sciences Research Laboratories, Department of Zoology, University of the Punjab, Lahore, Pakistan.
Medical Oncology Unit, HMC, Peshawar, KP, Pakistan.
Pak J Pharm Sci. 2020 Mar;33(2(Supplementary)):861-870.
The outcome of chronic myeloid leukemia has been greatly improved by the use of Imatinib (IM), a selective BCR/ABL kinase inhibitor. The aim of present study was to report long term follow-up & outcome of IM-treated CML patients along with their clinicopathological features, risk group stratification, adverse events and to compare it with CML patients reported from western countries. The mean follow-up of 123 CML patients was 5.5 years in present study, who were treated with frontline IM 400mg daily in a tertiary care hospital in Pakistan. Risk stratification scores, response to treatment (ELN guidelines) and survival outcomes estimated by Kaplan-Meier analysis. Mean age: 35 years (9-67 years) and M: F: 1.5:1, mean follow up time: 5.5 years (1-15 years). Overall survival (OS): at 5.5, 8, 10 and 12 years were 93%, 88%, 81% and 73%, respectively. Progressions free survival (PFS) was 95%, 83%, 83% and 78% at 5.5, 8, 10 and 12 years, respectively. OS estimate by Sokal score was significant (P-value: 0.0019). Additional chromosomal aberrations: 1.6%. Eighteen (14.6%) patients progressed to AP/BC. Adverse events were moderate and tolerable. We present findings from a long term follow up of CML patients treated with IM in a developing country. CML mean age at onset was considerably lower than the western populations. Furthermore, 5.5 years OS are comparable to western CML population. IM in our patients as frontline choice proved to be very effective. IM was found to be well tolerated, safe with manageable moderate side effects.
伊马替尼（IM）是一种选择性 BCR/ABL 激酶抑制剂，它的使用极大地改善了慢性髓性白血病（CML）的预后。本研究旨在报告 IM 治疗的 CML 患者的长期随访结果和结局，以及他们的临床病理特征、风险分层、不良事件，并将其与来自西方国家的 CML 患者进行比较。本研究中，123 例 CML 患者在巴基斯坦的一家三级护理医院接受了一线 IM 400mg 每日治疗，中位随访时间为 5.5 年。采用风险分层评分、治疗反应（ELN 指南）和 Kaplan-Meier 分析估计生存结果。平均年龄为 35 岁（9-67 岁），M：F 为 1.5：1，平均随访时间为 5.5 年（1-15 年）。5.5、8、10 和 12 年的总生存率（OS）分别为 93%、88%、81%和 73%。5.5、8、10 和 12 年的无进展生存率（PFS）分别为 95%、83%、83%和 78%。Sokal 评分的 OS 估计具有显著意义（P 值：0.0019）。额外染色体异常：1.6%。18 例（14.6%）患者进展为加速期/急变期。不良事件为中度且可耐受。我们报告了在发展中国家使用 IM 治疗的 CML 患者的长期随访结果。CML 的发病年龄明显低于西方国家的人群。此外，5.5 年 OS 与西方 CML 人群相当。我们的患者中，IM 作为一线选择被证明非常有效。IM 耐受性良好，安全性高，副作用可管理。
