Online ISSN: 2515-8260

BCR-ABL type of mutation and hematology response to imatinib mesylate in chronic phase CML patient: a retrospective study in a tertiary referral hospital in Indonesia

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Mohamad Arif1 , Mardiah Suci Hardianti2*, Johan Kurnianda2 , Ibnu Purwanto2 , Kartika Widayati Taroeno-Hariadi2 , Susanna Hilda Hutajulu2

Abstract

Background: The BCR-ABL mutation types were reported influencing the treatment of Chronic Myelogenous Leukemia (CML) due to different responses to the use of tyrosine kinase inhibitor. However, the clinical score system, that is, EUTOS score is also considered as one essential factor in determining the treatment outcome. This study aims at observing the hematology response among chronic phase CML patients atSardjito Hospital Yogyakarta, Indonesia based on BCR-ABLmutation types, namely b3a2 and non-b3a2, with evaluation of EUTOS scores. Methods: A retrospective cohort of 72 subjects from January 2013 to November 2018 was analyzed according to mutation types and EUTOS scores to observe the hematological response within 6 months after initiation of Imatinib therapy. Results: Forty-eight subjects (66.7%) had b3a2 mutations, while others had non-b3a2 mutations. The median of spleen size was significantly higher in non-b3a2 mutations (p = 0.024). Only 49 subjects (68%) achieved the complete hematological response (CHR) within 6 months. The non-b3a2 mutation subjects were likely to have worse clinical and laboratory profiles than the b3a2 mutation subjects did (p > 0.05). The b3a2 mutation subjects tended toachieve earlier CHR than non-b3a2 mutation subjects (HR 1.031; p = 0.919). The latter subjects with high EUTOS scores had longer time to achieve the CHR (p = 0.781). Conclusion: Cases with non-b3a2 mutations were presented with worse clinical and laboratory profiles than those with b3a2 mutations. In addition, the non-b3a2 mutations with higher EUTOS scores tended to have longer time to achieve the CHR.

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