Faris Q Alenzi, Ali M. Al-Amri, Fahad G. B. Alanazi, Waleed Tamimi, Ayad Alanazi, Awwad K. Alenezy, Farhan Al- Swailmi


Background: The cyto-genetic hallmark of chronic myeloid leukaemia (CML), the Philadelphia
chromosome (Ph), is the first consistent chromosomal abnormality that has been associated to a certain
cancer type. In CML, Philadelphia chromosome is present leading to resistance to cell death and rapid
proliferation. The aim of this study is to evaluate the different responses, toxicity and survival of Saudi
CML patients to imatinib mesylate. Methods: All newly diagnosed CML patients who were treated
with imatinib were included in this study. We investigated haematological, and molecular and cytogenetic responses by CBC, FISH and RT-PCR respectively. Cell proliferation and apoptosis were
assayed using AUC and TUNEL respectively. Results: Of the 12 cases, 9 (75%) were males and 3
(25%) were female. Four (33%) of the cases were diagnosed incidentally and 8 cases (67%) presented
mainly with fatigue (75%), fever (58%), and splenomegaly (83%). Signs of bleeding and rashes were
rare at presentation. The majority of patients had low risk (8, 67%), and 33% had intermediate risk; but
none of them had high risk CML. At the last follow up, 11 (92%) were in remissions. One patient (8%)
was in remission after 3 years, 4 (33%) were in remission after 6 years, one was in remission after 7
years and 5 (42%) were in remission after 10 years. Only one patient had incomplete major molecular
response (MMR) to imatinib after 12 years. The majority of the patients (10, 83%) were in MMR after
6 years and 42% of them were in MMR after 10 years of therapy. Adverse effects of imatinib were not
reported by the patients. Imatinib treatment resulted in the reduction of proliferation and induction of
apoptosis of CML CFU-GM cells. Conclusion: Imatinib mesylate is capable of treating Philadelphia
chromosome-positive CP-CML without any adverse effects.
Keywords: Imatinib, Philadelphia, CML, responses

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