Efficiency of tyrosin kinase inhibitors in chronic phase CML patients: A single center experience

Objective: To examine the effectiveness of tyrosine kinase inhibitörs used in the treatment of chronic phase KML patients followed in our center and present real-life data as a single center and to determine the relationship between EMR and MMY response and disease outcomes in the long-term. Materials and Methods:184 patients, who applied to Gaziantep University Faculty of Medicine, Department of Internal Medicine, Şahinbey Research and Practice Hospital Hematology outpatient clinic between 2007-2021, received TKI treatment for at least 1 year, and whose cytogenetic and molecular responses were followed regularly, were included in the study.Survival analyzes were performed by Kaplan Meier analysis. Analyzes were carried out with the help of SPSS 22.0 program. A significance level of . p<0,05 was chosen. Results:There was no drug change in 124 (67.4%) patients who received imatinib mesylate as first-line therapy, and second-line therapy was initiated in 60 (32.6%) patients. Dasatinib treatment was started in 36 (60%) and nilotinib treatment in 24 (40%) of 60 patients who were switched to second-line therapy. Considering the reasons for second-line drug changes, it was seen that drug changes were made in 8 patients (4.3%) due to side effects and 52 patients (28.3%) due to loss of MMR. According to the PCR results at the 3rd month of the patiants receiving imatinib, 116 patients (63.3%) had an EMR, and 113 of these patients had PCR results at the 6th month, and MMR was achieved in 107 patients at the 12th month. TSY was achieved in 28 of 67 patients (36.7%) who could not obtain an EMR at the 3rd month. In 21 (11.4%) of these patients, MMR was obtained at 12 months. EMR, TSY or MMR could not be achieved in 29 (15.8%) of the patients. When all patients were examined, the mean survival (OS) was found to be 137.5±4.5 months. In patients receiving imatinib, the 5-year OS rate was 85.4%, and the 5-year progression-free survival (PS) rate was 62.8%. While the 3-year PS rate of the patients who received imatinib at 3 months was 94.4%, the 3-year PS rate of patients without EMR was 22.9%. A statistically significant difference was observed between patients with and without early molecular response under imatinib treatment (p:0.001). When the relationship between MMY status and PS at the 12th month in patients who received imatinib treatment was examined, the 3-year PS rate was found to be 85.9% in patients who received MMR, and 16.8% in patients who did not receive MMR. It was observed that the difference between the two groups showed a statistically positive correlation in favor of the group that received MMY and there was a significant relationship (p:0.001). Conclusion: When the patients who received imatinib were compared with patients who did not receive EMR,it was seen that the 5-year OS and 3-year PS were statitically positively correlated in favor of te patients who received EMR and there was a significant relationship(p:0.001) When the patients who received MMR and those who did not receive MMR were compaired with the 3-year PS ratio,it was observed that there was a statistically positive(p:0.001). Keywords: CML, TKİ, imatinib, adverse affect