Internal Medicine

doi: 10.25005/2074-0581-2019-21-3-380-386

K.Z. Urakov, V.Yu. Melnikova, G.B. Khodzhieva

Department of Internal Diseases № 3, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To study the manifestations of anemia syndrome in patients with chronic myeloid leukemia (CML) depending on the stage of the disease and on the background of Gleevec, Hydrea and anti-anemic drugs.

Methods: 117 patients with CML aged 16 to 85 years were examined. All patients were divided into two groups: the first group consisted of 99 patients who received hydroxyurea (Hydrea), the second group – 18 patients who received imatinib (Gleevec). As a baseline therapy, patients in the first group took Hydrea at a dose of 500 mg per day, depending on the number of white blood cells; the dose of the Hydrea was adjusted from 1 to 3 capsules 3 times a day. Patients of the II group in the chronic phase were assigned Gleevec at a dose of 400 mg/day, and in the phase of accelerated and blast crisis – 600-800 mg/day for 5-32 months. At the level of hemoglobin (Hb) ≤ 100g/l patients of both groups were prescribed the drug recombinant erythropoietin – Epoetin alpha (EPO, repretin). The drug was administered subcutaneously 200 IU 2-3 times a week. The duration of EPO therapy was, on average, 10.1±4.6 days.

Results: The effectiveness of treatment was assessed by increasing the level of Hb to 120 g/l or increasing its level by 20 g/l or more. In the chronic phase of CML, anemia was detected in a small number of patients, Hb averaged 101.4± 8.9 g/l, while in the accelerating phase Hb was reduced to 92.1± 3.1 g/l. This was especially evident during the blast crisis when the HB level reached 70.6±2.6 g/l. The characteristic was the reduction of reticulocytes in parallel with the progression of the disease (1,0±0,5-0,6±0,1). Leukocytosis is the chronic stage was 98.2±25.2×109 /l, and with the transition to the stage of accelerating there was its increase to 115.7±12.5×109 /l. In the case of the development of the blast crisis in the terminal stage, leukocytosis reached 121.3 to 17.5×109 /l.

Conclusion: The severity of the manifestations of the anemic syndrome in patients with CML depends both on the stage of the disease and on the quality of the therapy. In a comparative aspect, slightly more favorable results were obtained in the group of patients receiving a combination of Gleevec and EPO.

Keywords: Chronic myeloid leukemia , chronic stage, stage of accelerating, recombinant erythropoietin, Gleevec, Hydrea, anemic syndrome.

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Author information:

Urakov Komron Zokirovich Candidate of Medical Sciences, Assistant of the Department of Internal Medicine № 3, Avicenna Tajik State Medical University ORCID ID: 0000-0002-1027-7834

Melnikova Victoria Yurievna Assistant of the Department of Internal Medicine № 3, Avicenna Tajik State Medical University ORCID ID: 0000-0002-7168-3852

Khodzhieva Gulnora Boboevna Candidate of Medical Sciences, Associate Professor of the Department of Internal Medicine № 3, Avicenna Tajik State Medical University ORCID ID: 0000-0001-6575-3909

Information about support in the form of grants, equipment, medications

The work was carried out according to the plan of scientific research works of the Avicenna Tajik State Medical University (state registration number – 616.1/4). The authors did not receive financial support from manufacturers of medicines and medical equipment.

Conflicts of interest: No conflict

Address for correspondence:

Khodzhieva Gulnora Boboevna
Candidate of Medical Sciences, Associate Professor of the Department of Internal Medicine № 3, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (918) 626941


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