Chronic myeloid leukemia: an overview of the determinants of effectiveness and therapeutic response in the first decade of treatment with imatinib mesylate in a Brazilian hospital.
BACKGROUND
In the last decade, there has been a revolution in chronic myeloid leukemia treatment with the introduction of tyrosine kinase inhibitors with imatinib mesylate becoming the frontline therapy.


OBJECTIVE
To evaluate the therapeutic efficacy of imatinib mesylate in treating chronic myeloid leukemia patients and to identify factors related to therapeutic efficacy.


METHODS
This retrospective study was based on information obtained from patients' records in the Hematology Service of Hospital Universitário Walter Cantídio of the Universidade Federal do Ceará (HUWC / UFC). All patients diagnosed with chronic myeloid leukemia that took imatinib mesylate for a minimum of 12 months in the period from January 2001 to January 2011 were included. From a population of 160 patients, 100 were eligible for analysis.


RESULTS
The study population consisted of 100 patients who were mostly male (51%) with ages ranging between 21 and 40 years (42%), from the countryside (59%), in the chronic phase (95%), with high-risk prognostic factors (40%); the prognosis of high risk was not associated with complete hematologic response or complete cytogenetic response, but correlated to complete molecular response or major molecular response. Reticulin condensation was associated with complete hematologic response and complete cytogenetic response. It was found that 53% of patients had greater than 90% adherence to treatment. The high adherence was correlated to attaining complete cytogenetic response in less than 12 months. Moreover,20% of patients had good response.


CONCLUSIONS
Significant changes are indispensable in the monitoring of patients with chronic myeloid leukemia. Thus, the multidisciplinary team is important as it provides access to the full treatment and not just to medications.
Universidade Federal do Ceará, Fortaleza - UFC, Fortaleza, CE, Brazil.
Danielle Maria Camelo
DM
Cid
Universidade Federal do Ceará, Fortaleza - UFC, Fortaleza, CE, Brazil.
Silvia Maria Meira
SM
Magalhães
Universidade Federal do Ceará, Fortaleza - UFC, Fortaleza, CE, Brazil.
Acy Telles de Souza
AT
Quixadá
Universidade Federal do Ceará, Fortaleza - UFC, Fortaleza, CE, Brazil.
Rita Paiva Pereira
RP
Honório
Universidade Federal do Ceará, Fortaleza - UFC, Fortaleza, CE, Brazil.
Paola Franssinetti Torres Ferreira
PF
Costa
Universidade Federal do Ceará, Fortaleza - UFC, Fortaleza, CE, Brazil.
Samuel Roosevelt Campos
SR
Dos Reis
Universidade Federal do Ceará, Fortaleza - UFC, Fortaleza, CE, Brazil.
Selda Maria de Aguiar
SM
Carvalho
Universidade Federal do Ceará, Fortaleza - UFC, Fortaleza, CE, Brazil.
David Antonio Camelo
DA
Cid
Universidade Federal do Ceará, Fortaleza - UFC, Fortaleza, CE, Brazil.
Rafael Moura E
RM
Sucupira
Universidade Estadual do Ceará - UECE, Fortaleza, CE, Brazil.
Mariana Fátima Cabral
MF
de Oliveira
Antineoplastic combined chemotherapy protocols/therapeutic use; Leukemia, myelogenous, chronic, BCR-ABL positive/drug therapy; Piperazines/therapeutic use; Protein-tyrosine kinases/therapeutic use; Treatment outcome