Abstract:
Introduction: Chronic myeloid leukemia (CML) is a myeloproliferative disorder that results
from the reciprocal translocation of the ABL1 gene on chromosome 9 with the BCR gene on
chromosome 22, leading to the formation of the chimeric fusion oncogene. This myeloproliferative
malignancy accounts 15-20% of leukemias in adults. The course of CML istriphasic: chronic phase
(asymptomatic in approximately 30% of cases) followed by an advanced accelerated phase and/or
blast crisis, which may prove fatal. The treatment of CML has evolved over the years and currently
includes oral tyrosine kinase inhibitors, immunotherapy and bone marrow transplantation. Imatinib
was the first tyrosine kinase inhibitor to be introduced as first-line therapy.
Purpose and Objectives: Evaluation of clinical manifestations, contemporary methods of
diagnosis, assessment of therapeutic possibilities and treatment outcomes in patients with CML.
Materials and methods: The study was based on the analysis of the clinical observation
sheets of 50 patients diagnosed with CML.
Results: The study included 50 patients aged from 20 to 81 years: 28 men (56%) and 22
women (44%). According to the study, CML starts most frequently at the age o f 46-50 years (18%).
46 (92%) patients were diagnosed with CML in chronic phase. Only 3(6%) patients were diagnosed
during the acceleration phase and 1 (2%) patient - during the acute phase. 9 (18%) patients were
asymptomatic at the moment of diagnose. At least 35 (70%) patients presented a certain degree of
splenomegaly; 40 (80%) patients-asthenia, 37 (74%) patients- pressure in the left hypochondrium;
15 (30%) patients- bodyweight loss. 46 (92%) patients received chemotherapy, 37 (74%) patients
(74%) were treated with Imatinib. Only 2(4%) patients received Imatinib as a first line therapy. 36
(72%) patients had a complete remission (68% ensured by Imatinib); 14 (28%) patients - partial
remission (ensured by conventional therapy). In the first 6 months o f treatment, Imatinibdetermined
CMR in 5 (10% ) cases, CCR in 7 (14%) cases and CHR in 22(48%) cases. Only 3(6%) patients
experienced a relapse in less than a year after remission with Imatinib. On the other hand,8(16%)
patients with conventional therapy experienced recurrence during the same period of time.
Conclusion: The tyrosine kinase inhibitors represent the current most efficient therapy for
CML in chronic phase. The treatment discontinuation is almost invariably followed by a recurrence.
The introduction of targeted therapy has transformed this disease from an incurable malignancy to a
manageable chronic condition.