CYTOGENETIC AND MOLECULAR RESPONSE AFTER TREATMENT WITH TYROSINE KINASE INHIBITOR IN PATIENTS WITH CHRONIC MYELOID LEUKEMIA IN MARJAN MEDICAL CITY

Background: Chronic myeloid leukaemia (CML) is a stem cell disorder characterised by an acquired chromosomal abnormality known as the Philadelphia chromosome. It is likely that stopping BCR-ABL will be very important for the treatment to work. Tyrosine kinase inhibitors have significantly altered the prognosis of chronic myeloid leukaemia (CML). Methods: This retrospective study encompassed all patients with CML, in chronic, accelerated phase, and blast crisis, who received treatment with imatinib and nilotinib at Marjan Medical City in Babylon, aimed at evaluating the cytogenetic and molecular response to therapy. Results: A total of 115 patients with CML participated in a government-sponsored national program. Imatinib was the first drug given to all of the patients. After a median follow-up of 44 months, 80% had a major cytogenetic response, and 67% had a major molecular response. The rates of event-free survival, overall survival, and progression-free survival after five years were 82%, 97%, and 93%, respectively. A total of 38 patients (33%) were transitioned to Nilotinib; 27 patients attained MMR, while 9 patients exhibited no response. Conclusion: This study demonstrated that imatinib, administered as the first-line treatment for CML patients in Marjan Medical City, was well tolerated and produced results comparable to those observed in certain Iraqi Kurdistan and Western studies. Molecular monitoring significantly influenced treatment decisions. This study has validated that nilotinib is an efficacious treatment for imatinib-resistant cases and was necessary in one-third of patients, yielding favourable outcomes.