Clinico-haematological Profile of Chronic Myeloid Leukaemia: An Institutional Based Study from Bihar

Abstract

Introduction: Chronic Myeloid Leukaemia (CML) is a myeloproliferative disorder characterized by translocation between chromosome 9 and 22 resulting in Philadelphia (Ph) chromosome and BCR-ABL fusion gene. The final diagnosis of CML depends on demonstration of Ph chromosome or BCR-ABL fusion by cytogenetic or molecular studies which also contributes towards understanding the disease biology and has important implications in treatment and management of CML patients. Aim: This study evaluates the clinico-haematological profile of patients based on age, sex, haematological parameters, clinical presentations and frequencies of three phases of CML. Sokal and European Treatment and Outcome Study (EUTOS) scoring were performed. Materials and Methods: This was a retrospective observational study conducted over a period of 30 months that included 64 diagnosed patients of CML based on clinical examination, peripheral blood and bone marrow analysis and demonstration of BCR-ABL by Fluorescent In Situ Hybridization (FISH). Results: Of the 64 patients included in the study, the mean age of the subjects was 33 years with male preponderence (59.3%). The most common presenting symptom was low grade fever (89.0%). The frequency of patients in the Chronic Phase (CML-CP), Accelerated Phase (CML-AP) and Blast Crisis (CML-BC) were 41 (64.0%), 18 (28.1%) and 5 (7.8%) respectively. The most frequent age group to be involved was 20-35 years for CP, 41-50 years for AP and BC. All 64 cases showed BCR-ABL fusion and are doing well on follow-up except one patient which turned resistant to first generation Tyrosine Kinase Inhibitors (TKIs). Majority of the patients were in the low sokal scores (48.4%). Conclusion: In our study most CML patients were from younger age group, mean age being 33 years as compared to 45-55 years in western world. In contrast to other Indian studies majority of our patients belonged to low Sokal score and low EUTOS score. Males were more commonly affected than the females. As compared to western literature incidence of microcytic hypochromic anaemia is more in CML patients in this part of the world.

Keywords

• european treatment and outcome study score
• philadelphia chromosome
• sokal score