Журнал лейкемии
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Assessment of the Early Reachability of Major Molecular Response (MMR) in Chronic Phase of CML Patients on First and Second Generation Tyrosine Kinase Inhibitors (TKI): As Regard 1st and 2nd Line of Treatment

Mohamed AbdAllah Shazly*, Mohamed Osman Azzazi, Rasha Magdy Mohamed Said, Amina Ahmed Mohamed Allam

Background: CML treatment changed with the development of Tyrosine Kinase Inhibitors (TKIs) that interfered with the interaction between the BCR-ABL oncoprotein and Adenosine Triphosphate (ATP), blocking malignant clone proliferation.

Aim: To assess early reachability of Major Molecular Response (MMR) of CML patients in chronic phase on first and second generation TKI.

Patients and methods: MMR was assessed by quantitative PCR for BCR-ABL in 100 patients with newly diagnosed CML divided to three groups: First enrolled 40 patients on first generation TKI (imatinib) second enrolled 40 patients shifted from first generation (imatinib) to second generation (nilotinib) and third enrolled 20 patients on second generation (nilotinib) from the start. Patients were recruited from hematology department; Ain shams university hospital over the period from January 2018 to January 2019 and followed for 1 year.

Results: MMR at 12 months of treatment on nilotinib (first line) was higher than other groups (p= 0.025). Patients treated with imatinib 400 mg with additional cytogenetic abnormalities had high numbers of MMR failure (p=0.001) when compared to patients on nilotinib either 1st line or shifted. Patients with high SOKAL score started on imatinib 400 mg had high number of MMR failure in comparison to patients on nilotinib 300 mg (p<0.001). Complete Cytogenetic Response (CCR) at 6 and 12 months was higher in patients on nilotinib 300 mg than imatinib 400 mg (p=0.020).

Conclusion: Treatment with nilotinib as first line had better outcome than starting with imatinib or switching to nilotinib.