COMPARATIVE ASSESSMENT OF ANEMIC SYNDROME IN PATIENTS WITH CHRONIC MYELOID LEUKEMIA ON THE BACKGROUND TO THE GLEEVEC AND HYDREA THERAPY
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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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
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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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