Assessment of Treatment Outcome in Chronic Myelogenous Leukemia Patients on Tyrosine Kinase Inhibitors: Insight From a Resource Limited Setting

Abstract

BACKGROUND: Chronic myeloid leukemia (CML) is a hematologic malignancy characterized by the translocation t(9;22)(q34;q11.2), which results in a constitutively active tyrosine kinase. The introduction of tyrosine kinase inhibitors (TKIs) has significantly altered the disease course for patients with BCR-ABL1+ CML globally. OBJECTIVE: This study aimed to evaluate the treatment outcomes of CML patients in Ethiopia. METHODOLOGY: This was a single-center, cross-sectional study conducted on 330 patients diagnosed with CML, who were on TKI therapy and receiving follow-up at Tikur Anbessa Specialized Hospital (TASH). Data were collected from electronic medical records using a structured data abstraction tool. Chi-square statistics and binary logistic regression were employed to examine the associations between categorical variables, with statistical significance set at a p value < 0.05. A 95% confidence interval was used. RESULTS: The median age of patients was 37.0 years (interquartile range [IQR]: 29.0-49.3), and 185 (56.1%) of the patients were male. At diagnosis, 92.1% were in the chronic phase of CML, while 9 (2.7%) were in blast crisis. The complete hematologic response (CHR) rate at 3 months was 90.9% (291/320), while the CHR rate beyond 3 months was 90.2% (258/286). Multivariable logistic regression analysis showed that the likelihood of not achieving a complete/partial hematologic response was higher among those diagnosed in the advanced phase of CML (AOR: 6.114, 95% CI: 2.210, 16.910) and among patients requiring a treatment change (AOR: 5.765, 95% CI: 2.460, 13.512). CONCLUSION: The median age of CML patients in our study was notably young. The 3-month and overall hematologic responses were excellent. The initial phase of CML at diagnosis and treatment switch was associated with the 3-month CHR, while only treatment switch was associated with the overall CHR.