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2014, Number 4

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Rev Hematol Mex 2014; 15 (4)

The treatment of chronic myeloid leukemia: A single-center, 20-year experience

López-Hernández MA, Banda-García L, Alvarado-Ibarra M

Language: English
References: 41
Page: 164-173
PDF size: 413.10 Kb.


ABSTRACT

Background: Treatment of chronic myeloid leukemia (CML) Ph + has changed rapidly from chemotherapy to the use of inhibitors of tyrosine kinase, with progressively better results in terms of overall survival.
Objective: To analyze the results obtained with different types of treatment in patients with CML in the Hematology Department of Centro Médico Nacional 20 de Noviembre, Mexico City.
Material and method: An observational, longitudinal, retrospective, descriptive and comparative study was done with patients treated from 1990 to 2010, CML of novo, older than 15 years, both sexes. The clinical records were reviewed. Treatments were grouped into chemotherapy, busulfan or hydrea (CT), interferon (IFN), haematopoietic stem cell transplantation (HSCT), and inhibitors of tyrosine kinase (TKI).
Results: 206 patients were included and were submitted to: CT = 66, IFN = 42, HSCT = 35 (of them 8 were non-myeloablative), ITQ = 63. The greater likelihood of overall survival was achieved with ITQs and HSCT: 0.92 to 200 months and 0.52 to 250 months, respectively (p = 0.0001). Progression to phase accelerated or blastic were 4 and 2 (p = NS). Mortality was 9.5% and 48% (p = 0.001). The probability of overall survival with IFN or CT was less than 100 months.
Conclusion: TKIs are the best therapeutic option for Ph + CML. Without being curative, they allow long survivals with a commonly acceptable toxicity. The second option is HSCT which, although not universally applicable, is curative, with the inconvenience of a high morbiditymortality. These findings are similar to the reported in other centers.


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