Molecular response to tyrosine kinase inhibitors treatment evaluation of patients who have chronic myeloid leukemia.

Aim: To evaluate prognostic scores and molecular response to TKI treatment for patients who have chronic myeloid leukemia. Objectives: 1. To determine what part of CML patients belong to high risk prognostic groups using ELN recommendations. 2. To evaluate molecular response to Ist generation TKI treatment for patients who have CML. 3. To evaluate molecular response after treatment is changed to 2nd generation TKI treatment for patients who have CML. 4. To evaluate survival until changing of TKI generation and determine survival dependence upon CML phase. 5. To evaluate survival dependence upon CML prognostic score and molecular response achieved in one year. Methods: Study involves patients who are diagnosed with chronic myeloid leukemia at LSMUL KK. Using the patients’ medical records we gathered this information: age; gender; data needed to calculate Sokal, Hasford and EUTOS prognostic scores; used TKI; quantitative changes of molecular response (BCR – ABL1 test) while using 1st or 2nd generation TKI. The data analysis was performed using IBM SPSS Statistics 20 statistical analysis software. Results: 81 patients were involved in the study, 44,4% women and 55,6% men. More than a half 54,4% of them were in the 55-74 years old age group. 86,4% patients were diagnosed with chronic phase, 13,6% – acceleration phase of CML. After evaluating prognostic scores using EUTOS score – 87,6% of patients had a low risk score, 12,4% were put to high risk group. Patients who took 1st generation TKI – 37,6% patients achieved CMR, 13% – MMR, for 15,6% of patients response was insufficient, 25% – have not achieved any molecular response. After treatment were changed to 2nd generation TKI – 36,1% of patients achieved CMR, 25% – MMR, for 11,1% of patients response was insufficient, 19,45% – have not achieved any molecular response. The median progression free survival until changing of TKI are 6 – 8.9 years, 5 years progression free survival are 42.2%, 9 years progression free survival – 14.1%. Patients who were diagnosed with chronic phase of CML have better event - free survival than those with acceleration phase (p0.05). Patients who have reached at least MMR in 1 year of treatment have better event – free survival (p0,05). Not achieved MMR in 1 year of treatment worsen event free survival (p