Chronic Myeloid Leukemia (CML) at National Referral Hospital in Indonesia

Abstract

Chronic Myeloid Leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the Philadelphia chromosome and BCR-ABL fusion oncogene. CML is one of the illnesses that may be treated using Tyrosine Kinase Inhibitors (TKIs), a type of targeted therapy. Since TKIs are the standard of therapy, long-term survival of CML has improved compared to chemotherapy and interferon-alpha. For the first-line treatment for CML, there are four commercially available TKIs that serve as an integral part of the disease management. However, there are many challenges in diagnosing, treating, and monitoring patients with chronic phase CML in Indonesia. This study highlights the epidemiology data of chronic phase CML patients, particularly at Dr. Cipto Mangunkusumo General Hospital, an Indonesian national referral hospital, and how to diagnose, select first-line TKIs, and monitor the response of treatment after TKIs administration.

Myeloid Cell Leukemia-1 (MCL-1) and Its Correlation with the Prognostic Scoring System in Chronic Myeloid Leukemia

“…The sex ratio in studies in Asian countries ranged from 1.5-1.7:1, while in Caucasian countries (United States, United States of America, and surrounding races), it was around 1.3-1.6:1 [Reksodiputro, 2015], [Au, 2009]. Chronic myeloid leukemia is more common in Western countries than in Asia and tends to develop at an older age [Hochhaus, 2020] [Rajabto, 2022]. The average diagnostic age in the US is 67 years, while in Europe, it is between 60 and 65 years [Deininger, 2021] [Hochhaus, 2017].…”

“…The average diagnostic age in the US is 67 years, while in Europe, it is between 60 and 65 years [Deininger, 2021] [Hochhaus, 2017]. In Indonesia, China, Hong Kong, India, the Philippines, Singapore, South Korea, Thailand, and Malaysia, the average age is between 36 and 55 years, and the incidence is higher in men than women [Au, 2009], [Rajabto, 2022], [Kuan, 2018]. Overexpression of MCL-1 seen in several malignancies, including solid tumors and hematological malignancies, and it was the first to be discovered in leukemic cell lines myeloblastic humans in the early phase of differentiation [Pereira-Castro, 2022], [Senichkin, 2019], [Belmar, 2015], [Wei, 2020], and increased expression of this is associated with a poor prognosis [10].…”