Epidemiology Study and Mutation Profile of Patients with Chronic Myeloid Leukemia (CML) in Indonesia

Abstract

Aim: To assess CML patient's characteristic including demographic, clinical and hematological characteristic of patients with CML including quantitative BCR-ABL and BCR-ABL gene sequencing. Methods: This study was an open-label, single arm, non-randomized, cross sectional study in patients with CML being treated with imatinib mesylate (IM) from 12 centers. Result: A total of 100 patients were evaluated between January 1, 2009 and December 31, 2011. The median age was 34-35 years old (mean of age is 36 years old), and more patients in the productive age was found.-(?) were 80 of the 100 patients who had been examined for the BCR-ABL gene mutation with the sequencing method before consuming IM. Mutation in the P-loop was seen in 2,27% (1 out of 44 patients), this finding was beyond our expectation since 47,69% (31 out of 65 patients) of our patients did not achieved CHR at three months. On the other hand, 15,9% (7 out of 44 patients) of our patients had mutation outside the P-loop. Conclusions: The characteristics of CML patients in Indonesia were not different from CML patients in Asia in general. Our finding concerning the high frequency mutation in the BCR-ABL gene outside the P-loop needs further study.

Therapeutic Responses of Imatinib and Nilotinib among CML Patients in Hasan Sadikin Hospital Bandung

“…In this study we obtained samples as many as 244 patients. Within CML patients around the world, including Asia and Indonesia, the cases occur more often in male than female (8). But the result of our study showed equal percentages in male and female patients.…”

“…But the result of our study showed equal percentages in male and female patients. The median of age for CML cases in the world is 65 years old, while in Indonesia the median of age for CML cases is 36 years old, similar to the median of age for CML cases in Asia (8). But in this study we found that the median of age was 42 years old.…”

“…TKI resistance is defined by the inability of TKI drug to achieve pharmacological target, caused by the drug itself or by other factors acting as obstacles to achieve the treatment target (4). Resistance to TKI can be evaluated by hematologic response, cytogenetic response, and molecular response after a certain amount of time (5,6) From a multicentre study in Indonesia, the rate of resistance to TKI is higher (47.69%) than in Europe (around 24%) (7,8). Until now in Indonesia, specifically in West Java there has not been any study describing resistance to TKI, in patients using first-line drug (imatinib) and patients using second-line drug (nilotinib).…”

Perbandingan Skor Sokal dan Skor Hasford terhadap Respons Terapi Imatinib Mesylate pada Pasien Leukemia Granulositik Kronis di Rumah Sakit dr. Saiful Anwar Malang

“…18 Sedangkan, pada penelitian di RSCM Jakarta tahun 2009 didapatkan angka CHR pada bulan ke-3 sebesar 62,3%. 16 Pasien yang tidak mencapai respons hematologi komplet pada bulan ke-3 harus mendapat perhatian khusus mengenai kepatuhan minum obat, ketepatan waktu minum obat, cara minum obat dan faktor lainnya yang memengaruhi bioavailabilitas obat termasuk kemungkinan resistensi. 19 Apabila dalam kurun waktu 3-6 bulan setelah mendapat terapi, pasien tidak mencapai respons hematologi komplet maka dikatakan sebagai resistensi primer hematologi.…”

Differences of Bone Marrow Features and BCR-ABL Variants in Chronic Granulocytic Leukemia Post Tyrosine Kinase Inhibitor Therapy

“…30-40% of CGL patients are asymptomatic. However, clinical manifestations and symptoms of CGL patients are associated with [1][2][3] leukocytosis, splenomegaly or anemia.…”