Clinicopathological characteristics of CML in children and young adults.

Abstract

e19029 Background: CML, although a disease of middle age, is not uncommon in younger age groups in developing countries like Pakistan. Methods: In this single center, cross sectional study, all patients diagnosed with CML below 30 years of age were enrolled. After collection, data was analyzed using Spss version 23.Quantitative variable were presented as mean and percentages. Chi-square was used for correlation between variables with p<0.05 considered significant. Results: Total 101 patients, with age range 7-30 years (mean 21.99±6.3), including 18(17.8%) below 15 years, were enrolled. Fever was most common presenting symptoms seen in 61(60.4%) followed by fatigue, abdominal distension in 40(39.6%) and 33(32.7%).Mean presenting TLC was 158.9±136.95. Of these, 97(96.03%) patients were in chronic phase, 3(2.97%) had accelerated and 1(1%) in blast phase. As per SOKAL score, 27 (26.73%), 51(50.49%) and 23(22.77%) had low, intermediate and high risk disease respectively. Imatinib was started in 80.19% while Nilotinib in 19.80% as 1st line TKI. Among these, 88.1% achieved CHR by end of 3rd month. After 1st year, 60.8% achieved a molecular response (MR≥3). 1(1%) transformed from chronic to blast phase.2nd line TKI was started in 13.8% due to lack of response. Grade ¾ thrombocytopenia and grade ½ per-orbital edema were main toxicities seen in 10.7% and 9.6% respectively. Co-relation of increasing age with high TLC (p=0.039) and better response to TKI (p=0.014) was statistically significant. Conclusions: Distinct clinical behavior of CML in children and young adults necessitates further studies to ensure better disease management.[Table: see text]