THE EFFECT OF IMATINIB MESYLATE IN NEWLY DIAGNOSED PHILADELPHIA CHROMOSOME-POSITIVE, CHRONIC-PHASE MYELOID LEUKEMIA IN SUB-SAHARAN AFRICAN PATIENTS: THE EXPERIENCE OF CÔTE D’IVOIRE

Abstract

Objective: Imatinib mesylate has shown encouraging activity in chronic myelogenous leukemia (CML). However, to the best of our knowledge, there are few data regarding imatinib efficacy and response monitoring in Sub-Saharan African patients. Our objective was to assess response to imatinib in Côte d’Ivoire patients with newly diagnosed CML. Experimental Design: From May 2005 to September 2009, we treated 42 patients ( median age 40 years; age range, 16–69 years) with Philadelphia chromosome (Ph)-positive chronic phase CML with oral imatinib mesylate at daily doses of 400 mg at the national division of Haematology teaching Hospital of Yopougon–Abidjan (CHUY). Overall survival (OS) and frequency of complete or major cytogenetic remission (CCR/MCR) were evaluated. Results: At a median follow-up of 31(range, 7.6-113) months, the CHR rate in our study group was 76%. A major cytogenetic response has been found in 19 patients (45%) among which 17% and 28% display complete and partial remission respectively. There were no significant differences in the incidence of major cytogenetic response in relation to known prognostics factors, at the exception of cytogenetic profile prior to treatment with better response to Ph+ alone. The median time to CHR was 8 months (range, 0.4-25 month), and the median time to cytogenetic response was 16 months (range 0.1-36 month). The projected 5-years overall survival rate was 72%. Conclusions: Compared to treatment outcome with conventional chemotherapy, as previously used in Sub-Saharan Africa, this result has established imatinib as the first-line treatment strategy in patients with CML, as reported in other populations, with minimal morbidity.

Keywords

• leukemia
• Imatinib Mesylate
• Chronic Myeloid Leukemia
• Sub-Saharan African patient
• survival.