Chronic myeloid leukaemia in the South African public health setting: Are we reaching the European LeukemiaNet targets for frontline therapy?

Abstract

Background: Successful therapy of chronic myeloid leukaemia (CML) relies on close monitoring of patients’ response to therapy using the standardised real-time quantitative polymerase chain reaction (RQ-PCR) or fluorescent in situ hybridisation (FISH) at 3, 6 and 12 months. The European LeukemiaNet has published recommended therapeutic targets for frontline therapy at specific time points. Imatinib, a tyrosine kinase inhibitor, is used for the frontline treatment of chronic and accelerated phase CML in our setting. Aim: The aim of this study was to evaluate treatment response of patients with CML in chronic or accelerated phase treated with imatinib during the first 2 years of therapy. Setting: Universitas Academic Hospital, South Africa. Methods: In this analytical cohort study, a retrospective file review of all chronic and accelerated phase CML diagnosed between 2009 and 2016, who were initiated on imatinib as front-line therapy, was performed. Clinical and laboratory data were collected for different time intervals as recommended by European LeukemiaNet guidelines. Results: Thirty-seven patients met the inclusion criteria. An optimal response was obtained in 82.6%, 54.2%, 50.0% and 66.7% of patients at 3, 6, 12 and 18 months, respectively. Conclusion: The patient outcomes were comparable with other published studies, with two-thirds of patients achieving an optimal response at 18 months. It is important, however, that factors contributing to suboptimal responses in the remaining third of patients should be explored.

Keywords

• chronic myeloid leukemia
• cml
• outcomes
• frontline therapy
• tyrosine kinase inhibitors
• imatinib