%0 Journal Article
%T Patan hospital experience in treating philadelphia chromosome/BCR-ABL1 positive chronic myeloid leukemia patients with gleevec (imatinib mesylate); the first generation specific tyrosine kinase inhibitor
%A Gyan K Kayastha
%A Padma Gurung
%A Paras K Acharya
%A Buddhi P Paudyal
%A Bruce Hayes
%A Mark Zimmerman
%A Arjun Karki
%A Aaron S Mansfield
%J BMC Blood Disorders
%D 2010
%I BioMed Central
%R 10.1186/1471-2326-10-8
%X A total of 106 Philadelphia positive CML patients were enrolled in our center between Feb 2003 and Jun 2008, and 103 of them were eligible for cytogenetic and/or hematologic response analyses.Out of 103 patients, 27% patients underwent cytogenetic analysis. Imatinib induced major cytogenetic responses in 89% and complete hematologic responses in almost 100% of the patients with confirmed CML. After a mean follow up of 27 months, an estimated 90% of the patients on imatinib remained in hematologic remission and more than 90% of the patients are still alive. About 30% of patients developed some form of manageable myelosuppression. A few patients developed non-hematologic toxic side effects such as edema and hepatotoxicity.Our study demonstrates that imatinib is safe to use in a developing country. Furthermore, we demonstrate that imatinib is very effective and induced long lasting responses in a high proportion of patients with Ph chromosome/BCR-ABL1 positive CML. Imatinib is well tolerated by our patients. The lack of cytogenetic analysis in the majority of our patients hindered our ability to detect inadequate responses to imatinib and adjust therapy appropriately.Chronic myeloid leukemia (CML), is a myeloproliferative disorder caused by a translocation between chromosomes 9 and 22 that results in the Philadelphia (Ph) chromosome [t(9;22) (q34;q11)] [1]. The Ph chromosome was found to encode a reconstituted fusion gene known as BCR-ABL1, which is the principal cause of CML[2]. The BCR-ABL1 fusion gene encodes the BCR-ABL1 oncoprotein. This oncoprotein, which is constitutively active due to its uncontrolled tyrosine kinase activity, activates signal transduction pathways that lead to DNA replication and cell proliferation[3-5].The incidence of CML is similar in countries around the world and may affect ethnic groups equally. The annual incidence of CML in the US is 1.6 cases per 100,000 adults (approximately 5000 new cases per year), with a male-to-female ratio of 1.
%U http://www.biomedcentral.com/1471-2326/10/8