AYM Nazim Uddin1, Mohiuddin A Khan2, Salma Afrose3, Akhil R Biswas4, Tasneem Ara5,
Mafruha Akhter6, Alamgir Ahmed7, Tanzil Sajjad8
1. Assistant Professor, Haematology, North East Medical College Hospital, Sylhet
2. Professor of Haematology and BMT, DMCH, Dhaka
3. Professor of Haematology and BMT, DMCH, Dhaka
4. Professor of Haematology CMCH, Dhaka
5. Professor of Haematology and BMT, Ahsania Mission Cancer & General Hospital, Dhaka
6. Associate Professor of Haematology and BMT, DMCH, Dhaka
7. Associate Professor, Clinical Pathology, Dhaka Shishu Hospital
8. Associate Professor, Community Medicine & Public Health. Sylhet Women’s Medical College Hospital
Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative disorder caused by the Philadelphia chromosome (Ph) resulting in the BCR-ABL fusion gene, which encodes a constitutively active tyrosine kinase. Tyrosine kinase inhibitors (TKIs) target this kinase, aiming to achieve major molecular responses (MMR) for optimal treatment outcomes. The general objective of this study is to observe the molecular response status of CML. patients on regular TKI therapy at 6-month and 12-month intervals and specific Objectives are to evaluate the number of patients achieving early molecular response (EMR) and to identify number of patients with optimal response or therapy failure. Methods: An observational cross-sectional study involving 50 CML patients was conducted at Haematology department, Dhaka Medical College Hospital. BCR-ABLI transcripts were measured using qRT-PCR at 6 and 12 months. Data were collected via structured questionnaires and analyzed using SPSS 24. Results: At 6 and 12 months major molecular-response (MMR) was achieved in 26% and 50% of patients, respectively, with 34% showing new major molecular-response (MMR) at 12 months. Molecular response deteriorated in 10% and remained unchanged in 16% European Leukaemia Network (ELN) criteria indicated optimal responses in 68% and 50% at 6 and 12 months, respectively, EUTOS low-risk patients had higher MMR rates than high-risk patients. TKJ therapy significantly reduces BCR-ABL transcript levels over time, with improved outcomes observed with longer treatment durations. Further studies are warranted to validate these findings in broader populations.
Key Words: Chronic myeloid leukemia (CML), Tyrosine kinase inhibitors (TKIs). Major molecular responses (MMR)