Research Article: Imatinib Mesylate Effectiveness in Chronic Myeloid Leukemia with Additional Cytogenetic Abnormalities at Diagnosis among Black Africans

Date Published: May 29, 2013

Publisher: Hindawi Publishing Corporation

Author(s): Tolo Diebkilé Aïssata, Duni Sawadogo, Clotaire Nanho, Boidy Kouakou, N’dogomo Meité, N’Dhatz Emeuraude, Ayémou Roméo, Sekongo Yassongui Mamadou, Paul Kouéhion, Konan Mozart, Gustave Koffi, Ibrahima Sanogo.


Imatinib mesylate provides good results in the treatment of CML in general. But what about the results of this treatment in CML associated with additional cytogenetic abnormalities at diagnosis among black Africans?
For this, we retrospectively studied 27 cases of CML associated with additional cytogenetic abnormalities, diagnosed in the department of clinical hematology of the University Hospital of Yopougon in Côte d’Ivoire, from May 2005 to October 2011.
The age of patients ranged from 13 to 68 years, with a mean age of 38 years and a sex ratio of 2. Patients were severely symptomatic with a high Sokal score of 67%. CML in chronic phase accounted for 67%. The prevalence of additional cytogenetic abnormalities was 29.7%. There were variants of the Philadelphia chromosome (18.5%), trisomy 8 (14.8%), complex cytogenetic abnormalities (18.5%), second Philadelphia chromosome (14.8%), and minor cytogenetic abnormalities (44.4%). Complete hematologic remission was achieved in 59%, with 52% of major cytogenetic remission. The outcome was fatal in 37% of patients. Death was related in 40% to hematologic toxicity and in 30% to acutisation. The median survival was 40 months.

Partial Text

Chronic myeloid leukemia (CML) is characterized by the predominant proliferation of cells of grainy line and by the existence of a cytogenetic abnormality that is the translocation t (9; 22) (q34; q11) with BCR/ABL rearrangement.

Our study was carried out in the department of clinical hematology of the University Hospital of Yopougon in Abidjan, Côte d’Ivoire. It was retrospective and descriptive. It involved records of in-patients or out-patients from May 2005 to October 2011. All in-patients or out-patients with CML diagnosed by blood count, myelogram, and cytogenetic or molecular biology with additional chromosomal abnormality and treated by imatinib mesylate were included. Twenty-seven CML patients with additional cytogenetic abnormalities treated by imatinib mesylate were retained.

From May 2005 to October 2011 the diagnosis of CML was made in 91 patients. Among these 91 patients, 27 were carriers of additional cytogenetic abnormalities, that is, 29.7% (Table 2). The epidemiological, clinical, and biological features of those patients are summarized in Table 1. The age ranged from 13 to 68 years with an average of 38 years. The sex ratio was 2.

The mean age of our patients was 38 years with extremes of 13 and 68 years. Our lower average age also reported by other authors [6] could be related to the pyramid of ages of the African people.




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