Clinical Report: Patterns of Treatment and Outcomes with TKIs in CML
Overview
This study evaluates treatment patterns and outcomes of tyrosine kinase inhibitors (TKIs) in chronic myeloid leukemia (CML) patients in Oman. Key findings include the rates of treatment-free remission (TFR).
Background
Chronic myeloid leukemia (CML) is characterized by the BCR-ABL1 fusion gene, leading to the development of targeted therapies such as tyrosine kinase inhibitors (TKIs). Real-world data on their use and outcomes in the Middle East are limited.
Data Highlights
Parameter
Value
Mean Age
43.7 ± 15.4 years
Low Sokal Risk
45%
First-line Imatinib MMR
51%
Second-line Nilotinib MMR
79.2%
Successful TFR (Imatinib)
17% after 2 years
Successful TFR (Second-line)
83.3% after 36 months
Grade 3-4 ADRs
5%
Key Findings
88.4% of patients received imatinib as first-line therapy.
Major molecular response (MMR) was achieved in 51% of imatinib patients.
Second-line TKIs showed higher MMR rates: 79.2% for nilotinib and 54.4% for dasatinib.
Successful treatment-free remission (TFR) was maintained in 17% of imatinib patients and 83.3% of second-line patients.
Adverse drug reactions (ADRs) were primarily gastrointestinal (28.5%) and musculoskeletal (28.0%).
Discontinuations were mainly due to loss of response, ADRs, or planned TFR.
Clinical Implications
The findings suggest that second-line TKIs may offer superior efficacy and TFR rates compared to first-line imatinib. Clinicians should consider a response-guided, risk-adapted approach to TKI selection to optimize patient outcomes.
Conclusion
This study highlights the findings related to treatment patterns and outcomes for patients with CML in Oman.
