The relationship of clinical and laboratory features at diagnosis with the treatment response in patients with chronic myeloid leukemia; Retrospective study

OBJECTIVE: CML is the first human malignancy found in animals with the Ph chromosome including BCR-ABL. Before the use of tyrosine kinase inhibitors (TKIs), the median survival was 5-7 years. Theuse of TKI sincreased the 10-year average survival rate by approximately 80-90%. With the participation of TKI, new prognostic scoring sites have been used for treatment responses and survival. ELTS is the currently used prognostic scoring system for people using TKI. Weaimed to investigate the effect of clinical and laboratory features at the time of diagnosis on treatment response in CML patient sunder treatment with TKI. METHODS: 50 CML patients diagnosed and followed up by Tekirdağ Namık Kemal University Faculty of Medicine Hematology Clinic between 2010-2022 were included in ourstudy. Demographic data of the patients, complete blood count results (hemoglobin, leukocyte, platelet, eosinophil and basophil criteria in peripheral smear), presence of splenomegaly, treatments received, complete cytogenetic response (CCR) and majör molecular response (MMR) , risk scores, peripheral blood smear and BCR-ABL gene transcript measurements were taken retrospectively. RESULTS: 50 CF-CML patients, 19 female and 31 male, were included in ourstudy. While only imatinib was given in 25 of the CML patients, it was passed in the second step in 25 patients. In our study, patients with lower leukocyte counts at the time of diagnosis had a higher rate of CCR and MMR in thefirst-line treatment. In addition, the rate of presence of CCR was found to be lower in patients with higher platelet count at the time of diagnosis. It was observed that patients with high Hgb values achieve dearlier CCR and MMR. Splenomegaly asset effect on 6th, 9th, 12th month CCR and 12th, 24th month MMR was found to be statistically effective in our single factor and 24th month MMR multi-factor analysis. High-risk Hasford, EUTOS, ELTS scores, andlow-risk groups CCR rates were lower. CONCLUSION: As the anemia deepened in CML patient sparticipating in ourstudy, it was interpreted as negatively affecting the treatment response. High basophil ratio in peripheral smear at the time of diagnosis, high leukocyte and platelet counts were found in those living with a poor prognosis. At the time of diagnosis, the negative effect of splenomegaly examination treatment was detected. It was observed that the high-risk Hasford, EUTOS, ELTS scores decreased the incidence of CCR compared to the low-risk class. Key Words:Chronic Myeloid Leukemia, Tyrosine Kinase Inhibitors, Prognosis, Incidence