IMATINIB MESYLATE IN IRAQI PATIENTS WITH CHRONIC MYELOID LEUKEMIA

Abstract

Background: Chronic myeloid leukemia (CML) is a clonal proliferation of stem cells that is characterized by granulocytosis with granulocytic immaturity. The molecular abnormality involving the ABL gene on chromosome 9 and the BCR gene on chromosome 22 have been established as being the proximate cause of chronic phase CML.Objective: To study the clinical, and hematological responses to imatinib mesylate and the main side effects in Iraqi patients with CML in the three phases of disease.Methods: Three hundred and sixty two patients with CML were enrolled .they were diagnosed by peripheral blood and bone marrow aspirate examination and were treated with imatinib mesylate 400 mg/day as one single dose orally and followed up every 4 weeks for clinical , hematological responses and evaluation of side effects.Results: The frequency of CML cases by residence was 17. 40%, 21.8% and 61.6% from south, north and middle regions of Iraq respectively. The age of patients ranged 14-70 years, 192 males (53%) and 170 females (47%). Complete clinical and hematological responses were observed in 325 (90%) of patients within 3 months from the initiation of imatinib in the chronic phase of the disease, only 4/10 responded in the accelerated phase at higher dosage of 600-800mg/day , no one in the blastic phase responded. Side effects were generally mild and tolerable. Conclusion: Imatinib mesylate is effective and safe in achieving high clinical and hematological responses in chronic phase CML patients, but has poor response in accelerated and acute blastic phases. Side effects are generally mild. Key words: Chronic Myeloid Leukemia, Imatinib Myseglate