KRONİK FAZ KRONİK MYELOİD LÖSEMİDE HEDEFE YÖNELİK TEDAVİNİN GERÇEK HAYATTA UZUN DÖNEM İZLEM SONUÇLARI: TEK MERKEZ DENEYİMİ

Amaç: Kronik myeloid lösemi (KML), myeloid seri hücrelerinde aşırı ve kontrolsüz çoğalmayla karakterize olan bir hematopoetik kök hücre hastalığıdır. Tirozin kinaz inhibitörleri (TKİ) ile KML tedavisinde başarı yüksek oranda artmıştır. Bu hastaların uzun dönem takibinde hedefe yönelik tedavinin yan etki yönetimi, yanıt kaybı ve ilaca direnç mekanizmalarının yakından izlemi klinik pratikte önem kazanmıştır. Bu çalışmada da ünitemizde tedavi alan ve takip altında olan kronik faz KML hastalarının klinik seyirlerinin geriye dönük değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Haziran 2001 - Aralık 2016 tarihleri arasında tanı almış, TKİ ile tedavi edilen 72 kronik faz KML olgusunun sonuçları geriye dönük olarak değerlendirilmiştir. Bulgular: Çalışmaya tanı anı medyan yaşı 40 (16-66) olan 36 (%50)’sı kadın ve 36 (%50)’sı erkek toplam 72 olgu dahil edildi. Tanı sonrası takip süresi medyan 88 (20-207) ay, toplam sağ kalım ise medyan 92,5 (21-207) ay idi. Halen takipte olan 68 olgunun 65 (%95,6)’inin majör moleküler yanıt ile ve 3 (%4,4) olgunun ise tam sitogenetik yanıt ile takip edildiği gözlendi. Sonuç: Kronik faz KML olgularında prognoz, son 20 yılda TKİ’lerinin klinik pratiğe girmesiyle dramatik bir şekilde iyileşmiştir ve yaşam beklentisi genel sağlıklı popülasyona yaklaşmıştır. KML hastalarının günlük pratik izleminde, kılavuzlarda ki önerilere azami düzeyde uyulmalıdır.

Anahtar Kelimeler:

myeloid lösemi, kronik, kronik faz

LONG TERM TREATMENT RESULTS OF TARGETED THERAPY IN CHRONIC PHASE CHRONIC MYELOID LEUKEMIA: SINGLE CENTER EXPERIENCE

Purpose: Chronic myeloid leukemia (CML) is a hematopoietic stem cell disease characterized by excessive and uncontrolled proliferation in myeloid cells. Treatment success in CML has been significantly increased with tyrosine kinase inhibitors (TKIs). In the long-term follow-up of CML patients, side-effect management of targeted therapy, loss of response and close monitoring of drug resistance mechanisms have gained importance in clinical practice. The aim of this study was to evaluate the clinical course of chronic phase CML patients who were treated and followed up in our center, retrospectively.Material and Method: The results of 72 chronic phase CML patients treated with TKIs between June 2001 and December 2016 were evaluated retrospectively.Results: Seventy-two patients (36 (50%) female and 36 (50%) male) with a median age of 40 years (16-66) were included in the study. The median follow-up period was 88 (20-207) months and the median overall survival was 92.5 (21-207) months. Sixty-five (95.6%) of 68 patients who were still under follow-up had major molecular response and 3 (4.4%) had complete cytogenetic response. Conclusion: The prognosis of chronic phase CML patients has improved dramatically in the last 20 years with the introduction of TKIs into clinical practice, and life expectancy has approached the general healthy population. In the daily practical follow-up of CML patients, the recommendations in the guidelines should be strictly followed.

Keywords:

myeloid leukemia, chronic, chronic phase,

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