Cytogenetic Response in Chronic Myeloid Leukaemia Patients Treated with Imatinib Mesylate Homolog-Drugs: 6 Year’s Transitional Study — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Cytogenetic Response in Chronic Myeloid Leukaemia Patients Treated with Imatinib Mesylate Homolog-Drugs: 6 Year’s Transitional Study
Department of Haematology, Hiwa Hospital, Sulaymaniyah, Kurdistan Region, Iraq
,
Department of Haematology, Baghdad Teaching Hospital (Medical City), Baghdad, Iraq
,
Department of Haematology, Hiwa Hospital, Sulaymaniyah, Kurdistan Region, Iraq
,
Departmentof Immunology and Microbiology, Laboratory of Haematopathology and Immunology, Baghdad, Iraq
,
Department of Biochemistry, Faculty of Medical Sciences, School of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan Region, Iraq
1 Department of Haematology, Hiwa Hospital, Sulaymaniyah, Kurdistan Region, Iraq
2 Department of Haematology, Baghdad Teaching Hospital (Medical City), Baghdad, Iraq
3 Department of Haematology, Hiwa Hospital, Sulaymaniyah, Kurdistan Region, Iraq
4 Departmentof Immunology and Microbiology, Laboratory of Haematopathology and Immunology, Baghdad, Iraq
5 Department of Biochemistry, Faculty of Medical Sciences, School of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan Region, Iraq
Background: Treatment for Chronic Myeloid Leukaemia (CML) is mainly imatinib mesylate (IM) from original-brand, Glivec ? or generic-type homologs, Imatib ? . Materials and Methods: A collection of 149 CML patients was treated over a period of 6 years at Hiwa hospital. These patients were clustered into three groups: Group A was treated with Imatib for more than one year. All survivors of group A patients were switched to Glivec, classified as group B. Group C received only Glivec after June 2011. Imatib and Glivec are administered at doses 400-, 600- and 800-mg according to the CML stage. Results: Among group A patients, 68 (60%) were in complete haematological response (CHR), 32 (28.3%) developed acceleration and 13 (11.5%) patients were deceased. After switching to Glivec (group B), 69 (69%) patients remained in CHR, 10 (10%) patients weredeceased and 21 (21%) patients remained in acceleration. Of the 36 patients in group C, 33 (91.7%) were in CHR, 1 (2.8%) were in acceleration and 2 (5.5%) deceased. Those patients with CHR were tested randomly for BCR/ABL by FISH, and only 1/25 (4%) patients were found with complete cytogenetic response (CCyR) in group A, while 31/42 (73.8%) and 13/17 (76.5%) have CCyR in group B and C, respectively. Conclusions: Our results demonstrate a less cytogenetic response to treatment in patients of CML, who received the Imatib therapy, while a significant cytogenetic remission was found in patients with CHR after they switched to Glivec.
Fialkow, P.J., Jacobson, R.J. and Papayannopoulou, T. (1977) Chronic Myelocytic Leukemia: Clonal Origin in a Stem Cell Common to the Granulocyte, Erythrocyte, Platelet and Monocyte/Macrophage. American Journal of Medicine, 63, 125-130. http://dx.doi.org/10.1016/0002-9343(77)90124-3
Faderl, S., Talpaz, M., Estrov, Z., O’Brien, S., Kurzrock, R. and Kantarjian, H.M. (1999) The Biology of Chronic Myeloid Leukemia. The New England Journal of Medicine, 341, 164-172. http://dx.doi.org/10.1056/NEJM199907153410306
Griffin, J.D., Todd, R.F., Ritz, J., Nadler, L.M., Canellos, G.P., Rosenthal, D., Gallivan, M., Beveridge, R.P., Weinstein, H., Karp, D., et al. (1983) Differentiation Patterns in the Blastic Phase of Chronic Myeloid Leukemia. Blood, 61, 85-91.
Rowley, J.D. (1973) Letter: A New Consistent Chromosomal Abnormality in Chronic Myelogenous Leukaemia Identified by Quinacrine Fluorescence and Giemsa Staining. Nature, 243, 290-293. http://dx.doi.org/10.1038/243290a0
Shtivelman, E., Lifshitz, B., Gale, R.P. and Canaani, E. (1985) Fused Transcript of abl and bcr Genes in Chronic Myelogenous Leukaemia. Nature, 315, 550-554. http://dx.doi.org/10.1038/315550a0
Kurzrock, R., Gutterman, J.U. and Talpaz, M. (1988) The Molecular Genetics of Philadelphia Chromosome-Positive Leukemias. The New England Journal of Medicine, 319, 990-998. http://dx.doi.org/10.1056/NEJM198810133191506
Melo, J.V. (1996) The Molecular Biology of Chronic Myeloid Leukaemia. Leukemia, 10, 751-756.
Sawyers, C.L. (1999) Chronic Myeloid Leukemia. The New England Journal of Medicine, 340, 1330-1340. http://dx.doi.org/10.1056/NEJM199904293401706
Savage, D.G. and Antman, K.H. (2002) Imatinib Mesylate―A New Oral Targeted Therapy. The New England Journal of Medicine, 346, 683-693. http://dx.doi.org/10.1056/NEJMra013339
Hochhaus, A., Lin, F., Reiter, A., Skladny, H., van Rhee, F., Shepherd, P.C., Allan, N.C., Hehlmann, R., Goldman, J.M. and Cross, N.C. (1995) Variable Numbers of BCR-ABL Transcripts Persist in CML Patients Who Achieve Complete Cytogenetic Remission with Interferon-Alpha. British Journal of Haematology, 91, 126-131. http://dx.doi.org/10.1111/j.1365-2141.1995.tb05257.x
O’Brien, S.G., Guilhot, F., Larson, R.A., Gathmann, I., Baccarani, M., Cervantes, F., Cornelissen, J.J., Fischer, T., Hochhaus, A., Hughes, T., et al. (2003) Imatinib Compared with Interferon and Low-Dose Cytarabine for Newly Diagnosed Chronic-Phase Chronic Myeloid Leukemia. The New England Journal of Medicine, 348, 994-1004. http://dx.doi.org/10.1056/NEJMoa022457
Complete Haematological Response
Cytogenetic Remission
Hehlmann, R., Heimpel, H., Hasford, J., Kolb, H.J., Pralle, H., Hossfeld, D.K., Queisser, W., Loffler, H., Hochhaus, A., Heinze, B., et al. (1994) Randomized Comparison of Interferon-Alpha with Busulfan and Hydroxyurea in Chronic Myelogenous Leukemia. The German CML Study Group. Blood, 84, 4064-4077.
Talpaz, M., Kantarjian, H., Kurzrock, R., Trujillo, J.M. and Gutterman, J.U. (1991) Interferon-Alpha Produces Sustained Cytogenetic Responses in Chronic Myelogenous Leukemia. Philadelphia Chromosome-Positive Patients. Annals of Internal Medicine, 114, 532-538. http://dx.doi.org/10.7326/0003-4819-114-7-532
Druker, B.J., Tamura, S., Buchdunger, E., Ohno, S., Segal, G.M., Fanning, S., Zimmermann, J. and Lydon, N.B. (1996) Effects of a Selective Inhibitor of the Abl Tyrosine Kinase on the Growth of Bcr-Abl Positive Cells. National Medicine, 2, 561-566. http://dx.doi.org/10.1038/nm0596-561
Druker, B.J., Guilhot, F., O’Brien, S.G., Gathmann, I., Kantarjian, H., Gattermann, N., Deininger, M.W., Silver, R.T., Goldman, J.M., Stone, R.M., et al. (2006) Five-Year Follow-Up of Patients Receiving Imatinib for Chronic Myeloid Leukemia. The New England Journal of Medicine, 355, 2408-2417. http://dx.doi.org/10.1056/NEJMoa062867
Hughes, T.P., Hochhaus, A., Branford, S., Muller, M.C., Kaeda, J.S., Foroni, L., Druker, B.J., Guilhot, F., Larson, R.A., O’Brien, S.G., et al. (2010) Long-Term Prognostic Significance of Early Molecular Response to Imatinib in Newly Diagnosed Chronic Myeloid Leukemia: An Analysis from the International Randomized Study of Interferon and STI571 (IRIS). Blood, 116, 3758-3765. http://dx.doi.org/10.1182/blood-2010-03-273979
Asfour, I.A. and Elshazly, S.A. (2009) Changing Therapy from Glivecto a “Copy” Imatinib Results in a Worsening of Chronic Myeloid Leukemia Disease Status: Two Case Reports. Cases Journal, 2, 9342. http://dx.doi.org/10.1186/1757-1626-2-9342
Mattar, M. (2010) Failure of Copy Imatib (CIPLA, India) to Maintain Hematologic and Cytogenetic Responses in Chronic Myeloid Leukemia in Chronic Phase. International Journal of Hematology, 91, 104-106. http://dx.doi.org/10.1007/s12185-009-0431-1
Goubran, H.A. (2009) Failure of a Non-Authorized Copy Product to Maintain Response Achieved with Imatinib in a Patient with Chronic Phase Chronic Myeloid Leukemia: A Case Report. Journal of Medical Case Reports, 3, 7112. http://dx.doi.org/10.1186/1752-1947-3-7112
Kantarjian, H.M., Dixon, D., Keating, M.J., Talpaz, M., Walters, R.S., McCredie, K.B. and Freireich, E.J. (1988) Characteristics of Accelerated Disease in Chronic Myelogenous Leukemia. Cancer, 61, 1441-1446. http://dx.doi.org/10.1002/1097-0142(19880401)61:7 3.0.CO; 2-C
Sokal, J.E., Baccarani, M., Russo, D. and Tura, S. (1988) Staging and Prognosis in Chronic Myelogenous Leukemia. Seminars in Hematology, 25, 49-61.
Kantarjian, H.M., Keating, M.J., Talpaz, M., Walters, R.S., Smith, T.L., Cork, A., McCredie, K.B. and Freireich, E.J. (1987) Chronic Myelogenous Leukemia in Blast Crisis. Analysis of 242 Patients. American Journal of Medicine, 83, 445-454. http://dx.doi.org/10.1016/0002-9343(87)90754-6
Baccarani, M., Saglio, G., Goldman, J., Hochhaus, A., Simonsson, B., Appelbaum, F., Apperley, J., Cervantes, F., Cortes, J., Deininger, M., et al. (2006) Evolving Concepts in the Management of Chronic Myeloid Leukemia: Recommendations from an Expert Panel on Behalf of the European Leukemia Net. Blood, 108, 1809-1820. http://dx.doi.org/10.1182/blood-2006-02-005686
Baccarani, M., Cortes, J., Pane, F., Niederwieser, D., Saglio, G., Apperley, J., Cervantes, F., Deininger, M., Gratwohl, A., Guilhot, F., et al. (2009) Chronic Myeloid Leukemia: An Update of Concepts and Management Recommendations of European Leukemia Net. Journal of Clinical Oncology, 27, 6041-6051. http://dx.doi.org/10.1200/JCO.2009.25.0779
O’Brien, S., Berman, E., Borghaei, H., Deangelo, D.J., Devetten, M.P., Devine, S., Erba, H.P., Gotlib, J., Jagasia, M., Moore, J.O., et al. (2009) NCCN Clinical Practice Guidelines in Oncology: Chronic Myelogenous Leukemia. Journal of the National Comprehensive Cancer Network, 7, 984-1023.