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

Abstract

Introduction: Chronic Myeloid Leukemia (CML) is a myeloproliferative malignancy with an estimated incidence in the world of 1-2 cases per 100,000 adults. The use of Tyrosine Kinase Inhibitors (TKI) as a therapy for CML is still the first choice for treatment, but some cases show a high level of resistance or intolerance to TKI therapy. This study aims to identify the therapeutic responses of imatinib and nilotinib among CML patients in Bandung.Method: This study is an analytical descriptive study of CML patients at Hasan Sadikin Hospital’s Hematology and Medical Oncology Outpatient Clinic in 2017. The total number of samples in this study is 244 patients, consisting of 199 patients with Imatinib therapy and 45 patients with Nilotinib therapy. The data is processed using SPSS Statistics 22.0 software.Result: The results showed that CML patients had a median age of 42 years, sex ratio of 1: 1 and the highest prevalence was in Bandung City (21.3%). Hematologic response is dominated by complete hematologic response, as high as 72.86% with Imatinib and 66.67% with Nilotinib. Molecular response 3-6 months post therapy is dominated by suboptimal response in as many as 36,8% with Imatinib and failure in as many as 50% with Nilotinib. Molecular response 12-18 months post therapy is dominated by failure in as high as 69,4% with Imatinib and 52,4% with Nilotinib.Conclusion: Based on the molecular response, the rates of suboptimal response and resistance are quite high. Regular monitoring standards of therapy for CML patients are needed to identify TKI resistance so alternative therapies can be provided to improve the outcomes.

Characteristic of Chronic Myelogenous Leukemia Patients at the Polyclinic of Oncology, Dr. Soetomo General Hospital, Surabaya in 2017

“…There are only two patients (6%) who are in the age range above 60 years. This result is in line with the results of a study conducted at Hasan Sadikin Hospital, Bandung, Indonesia, with mean age and median, respectively 41.5 years and 42 years (Sumantri et al, 2019). However, both results were still lower than the results obtained in Western countries.…”

Studi Epidemiologi Penderita Leukemia Granulositik Kronis pada Komunitas ELGEKA di Jawa Barat

“…Hasil penelitian serupa dengan penilitian di RSUP X Bandung pada tahun 2019. [11] Insidensi leukemia granulositik kronis tertinggi di usia 30-39 (38,1%) yang serupa dengan penelitian oleh Reksodiputro pada tahun 2015. [2] Dan penelitian di RSUPN Dr. Cipto Mangunkusumo.…”

“…[2] Obat paling banyak yang dikonsumsi adalah imatinib (71.4%), kemudian nilotinib(19.0%). Sejalan dengan penelitian di RSUP X Bandung, [11] Penelitian di Brazil. [8] Berdasarkan hasil penelitian dapat dilihat bahwa penderita leukimia granulositik kronis memiliki nilai BCR-ABL awal dominan yaitu >10% dan pada pemeriksaan akhir nilai BCR-ABL, dominan menurun menjadi <0,1%.…”

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

“…Di Amerika, diketahui rerata usia pasien saat terdiagnosis yaitu antara 55 -65 tahun, sedangkan di Eropa 60-65 tahun. 2,3 Penelitian di Indonesia seperti di Rumah Sakit dr. Cipto Mangunkusumo Jakarta, 4 Rumah Sakit Hasan Sadikin Bandung, 5 dan Rumah Sakit Sanglah Denpasar 6 menunjukkan rerata usia penderita LGK yaitu dalam rentang 36 -42 tahun.…”