Complete haematological response to Imatinib in chronic myeloid leukaemia patients attending the Ocean Road Cancer Institute in Tanzania

Abstract

Background: There is limited information on clinical characteristics, diagnosis and response to therapy of patients with chronic myeloid leukaemia (CML) in Tanzania. This hospital-based retrospective and cross-sectional study was conducted to describe the clinical and laboratory characteristics, time to diagnosis and response to first line therapy with imatinib in Philadelphia chromosome positive CML.

Methods: The study was conducted at the Ocean Road Cancer Institute in Dar es Salaam, Tanzania. Participants were sequentially recruited from the outpatient clinic where a structured questionnaire was employed seeking details socio-clinical features of the disease. Haematology indices at baseline and at three months of treatment was obtained from patient’s medical records. Haematological response was determined at three months of imatinib use using leukaemia net definition.

Results: Of 127 study participants, 63% were males. The mean (±standard deviation) age at diagnosis was 40 (±16) years, majority being in the third decade of life. Abdominal distention (88%) and symptoms of anaemia (84%) were the most frequent complaints. Splenomegaly (92%) and pallor (82.7%) were the common physical findings. The mean duration from consultation to diagnosis was 3(±0) weeks and mean duration from diagnosis to imatinib therapy initiation was 3 (±0.9) weeks. A total of 116 (91.3%) of patients had complete haematological response to imatinib therapy three months after therapy. There was significant decline in total white blood cell counts, basophils count, platelets and increase in haemoglobin at three months after imatinib therapy initiation.

Conclusion: Majority of patients were young with clinical and laboratory findings of severe disease. Patients presented late to hospital and there was a considerable long time to reach a final diagnosis and yet haematological response was still achieved in majority of these patients with imatinib therapy. The elucidated clinical and laboratory findings should advocate early CML diagnosis and immediate referral to a tertiary hospital.