الفهرس 
Review Of LiteratureOnly 14 pages are availabe for public view
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Abstract
Chronic myeloid leukemia (CML) is a malignant
hematologic disease that arises from the pluripotent
hematopoietic stem cells. According to the guidelines issued
by the European LeukemiaNet (ELN), BCR-ABL transcript
levels on the international scale (BCR-ABLIS) at 3 and 6
months are defined as indicators of the early efficacy of firstline
TKI treatment. A BCR-ABLIS ≤10% after 3 months of
TKI treatment or BCR-ABLIS <1% after 6 months of
treatment indicates an optimal response to TKI therapy with
no need to adjust the therapeutic strategy.
The present study aimed to investigate the impact of
early molecular response (EMR; BCR-ABL ≤ 10% on the
International scale [BCR-ABLIS] at 3 or 6 months) on
outcomes in patients with newly diagnosed chronic myeloid
leukemia in chronic phase treated with Nilotinib.
Results of the current study showed that (74.5%) of the
studied cases were male. Baseline serum creatinine (Scr)
was ≥1.4 mg/dL in (62.8%) of the studied cases. eosinophilia
was present in only (12.8%).In the present study, Baseline uric acid (UA) was <6
mg/dL in (62.8%) of the studied cases. Baseline peripheral
blasts were <5% in (86.2%) of the studied cases.
Splenomegaly was present in only (3.2%) of the studied
cases. Age at diagnosis was <55 in (87.2%) of the studied
cases.
The present study results showed that, Baseline total
leucocytic count (TLC) was ≥100k in (83.0%). Baseline Hb
was ≥10 mg/dL in (51.1%). Baseline platelet count
was ≥100k in (57.4%). Treatment compliance was found in
(96.8%) of the studied cases. Hematologic response was
found in (97.9%) of the studied cases.
In the current study, early molecular response (EMR)
was not achieved in four cases out of (94) studied subjects
and achieved in (90) studied cases. We noticed male
predominance in study cases achieved and not achieved
EMR representing 74.4% and 75.0%, respectively. There was
none statistically significant difference between the two
groups regarding gender.
The present study results showed that, in cases not
achieved EMR; the majority (75%) had Scr <1.4 mg/dL,
while in cases achieved EMR (64.4%) had Scr ≥1.4 mg/dL.There was none statistically significant difference between
the two groups regarding baseline Scr .
The current study results showed that, in cases not
achieved EMR; (25%) had eosinophilia and in cases
achieved EMR (12.2%) had eosinophilia. In cases not
achieved EMR; (50%) had UA ≥6 mg/dL and (50%) had
UA <6 mg/dL; while in cases achieved EMR (63.3%) had
baseline UA <6 mg/dL. There was none statistically
significant difference between the two groups regarding
baseline UA and baseline eosinophilia.
Regarding baseline peripheral blasts in the present
study; all cases not achieved EMR had peripheral
blasts ≥5%, while in cases achieved EMR (90%) had
peripheral blasts <5%. There was statistically significant
difference between the two groups regarding peripheral
blasts.
In our study, splenomegaly was found in (50%) of
cases not achieved EMR and in (1.1%) of cases achieved
EMR. There was statistically significant difference between
the two groups as regard splenomegaly.The present study results showed that, (75%) of cases
not achieved EMR were ≥55 years age at diagnosis; while
(90%) of cases achieved EMR were <55 years age at
diagnosis. There was statistically significant difference
between the two groups as regard age at diagnosis.
In the current investigation, TLC was ≥100k in all
cases not achieved EMR while (82.2%) were ≥100k in cases
achieved EMR. There was none statistically significant
difference between the two groups regarding TLC.
Regarding baseline Hb; (50%) of cases not achieved
EMR had Hb ≥10 mg/dL, while (51.1%) of cases achieved
EMR had Hb ≥10 mg/dL. There was none statistically
significant difference between the two groups regarding
baseline Hb.
The present study results showed that, (50%) of cases
not achieved EMR had baseline platelets ≥100k and (57.8%)
of cases achieved EMR had baseline platelets ≥100k. There
was none statistically significant difference between the two
groups regarding baseline platelets.
In our study, (25%) of cases not achieved EMR were
complaint, while all cases achieved EMR were complaint.There was statistically significant difference between the two
groups as regard compliance.
Results of the current study showed that hematologic
response was achieved in (50%) of cases not achieved EMR
and in (100%) of cases achieved EMR. There was
statistically significant difference between the two groups as
regard hematologic response.
Results of the current study showed that the median
OS was (95%CI: 128.580 – 381.420). The mean OS in cases
not achieved EMR3 was (95%CI: 219.210 – 415.290); the
mean OS in cases achieved EMR3 was (95%CI: 485.666 –
499.321) and the mean OS in cases achieved EMR3 was
(95%CI: 469.447 – 494.077).