Şerife SOLMAZ, İnci ALACACIOĞLU, Kadriye Bahriye PAYZIN

KRONİK MYELOİD LÖSEMİ HASTALARIMIZDA ALINAN YANITLARIN GERİYE DÖNÜK OLARAK DEĞERLENDİRİLMESİ

Giriş: Kronik Miyeloid Lösemi (KML) pluripotent kök hücrelerin myeloid progenitör hücrelerde artmış proliferasyon ve azalmış apoptozu ile karakterize klonal bir hastalığıdır. Ortalama görülme yaşı 45-55 dir. İnsidansı ise 1.5/100.000/ yıldır. Tirozin kinaz inhibitörleri (TKİ) KML’nin ana tedavisidir. Çalışmamızda KML tanısı ile tedavi alan hastalarımızın verileri geriye dönük olarak incelenmiş ve tedavi yanıtları sunulmuştur. Gereç ve Yöntem: Çalışmamızda 1995 - 2010 tarihleri arasında KML tanısı ile tedavi edilen 60 hastanın, demografik özelikleri, TKI sonrası dönemde, (birinci ve ikinci sıra TKI) hastaların tedavi yanıtları, TKİ yan etkileri ve hastaların toplam sağkalım (OS) durumları geriye dönük olarak incelendi. Bulgular: Olgularımızın 25'i kadın, 35'i erkek olup, medyan yaş 54,5’idi. Hastaların (n:60) TKI’ne tedavi yanıtları incelendi, 3. ay THY % 90, 12. ay TSY %76, 24. ay MMY %75 olarak gözlendi. Hastaların %77 ‘sinde ilk sıra tedavi olarak imatinib, %20 hastanın ise ARA-C ve interferon (IFN) ile başlandığı ve %20 hastada ise ikinci sıra TKIs tedavisi aldığı saptandı. Tüm KML hastalarında ortalama izlem süresi 57,5 ay (6-180). Hastalıksız sağkalım süresi 62 ay (51-73 ay) olduğu saptandı. Olguların tüm sağkalım oranı (OS) ise % 86 ve 3 yıllık toplam sağkalım oranı % 84 tü. Sonuç: KML hastalarının tedavisinde çığır açan TKI’ ların kullanıma girmesi ile tedavi yanıt oranları ve sağkalım oranları belirgin olarak artmıştır. Hastalarımızın kılavuzlara uygun şekilde yakın moleküler izlemi önemlidir. Böylece hastalarımızda uzun dönem sağkalım ve hastalıksız sağkalım elde edilebilir.

RETROSPECTIVE EVALUATION OF ACCEPTIVE ANSWERS IN CHRONIC MYELOID LEUKEMIA PATIENTS

Introduction: Chronic Myeloid leukemia (CML) is a clonal disease of primitive pluripotent stem cell characterized by decreased apoptosis and increased proliferation in myeloid progenitor cells. Mean age of diagnosis is detected by 45-55. The incidence is 1.5/100.000/ year. Tyrosine kinase inhibitors (TKI) are the main treatment of CML. The data of our patients treated with CML diagnosis were retrospectively reviewed, and treatment responses were presented. Material and Method: We retrospectively evaluated 60 CML patients, who demographic features, treatment responses of patients (first and second line TKI) ın the post-TKI period, TKIs toxicity profiles and TKIs treatment responses,overal survival of the CML patients in Dokuz Eylül University Department of Hematology between 1995 and 2010. Results: We found that 25 of the patients were women and 35 of the patients were men and median age was 54,5. Response to treatment with imatinib was evaluated. On this analysis, 90 % of patients treated TKIs had Complete Hematologic Response(CHR) at the 3. month, 76 % of patient treated TKIs had Complete Cytogenetic Response (CCR) at the12 month and 75% of patient treated TKIs had Major Molecular Response (MMR) at the 24. Month. 77% of the patients were given imatinib and 20% of the patients were given ARA-C and interferon (IFN) as the first line therapy. 20% of the patients were found to have second-line TKIs.The average follow-up period was 57,5 months ( 6-180 ) for all patients with CML. The duration of disease-free survival was 62 months (51-73 months). All of the patients survival (OS) was 86 %, and 3 year overall survival rates of 84%. Conclusion: The response rates and survival rates of treatment-induced TKIs in treatment of CML patients increased markedly.Close moleculer monitoring of our patients in accordance with the guidelines is important. Thus, long-term survival and disease-free survival can be achieved in our patients.

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