Background

Chronic myeloid leukemia (CML) originates in a pluripotent hematopoietic stem cell of the bone marrow and is characterized by greatly increased numbers of granulocytes in the blood. Myeloid and other hematopoietic cell lineages are involved in the process of clonal proliferation and differentiation. On the cellular level, CML is associated with a specific chromosome abnormality, the t(9; 22) reciprocal translocation that forms the Philadelphia (Ph) chromosome. The Ph chromosome is the result of a molecular rearrangement between the c-ABL proto-oncogene on chromosome 9 and the BCR (breakpoint cluster region) gene on chromosome 22.

Objectives

To compare the characteristics and remission rates after 6 months of therapy in CML patients treated with different tyrosine kinase inhibitors.

Material and methods

We conducted a case control study including 70 CML patients and 50 healthy controls. The cases were sub-grouped into two groups: imatinib and nilotinib.

Results

We enrolled 70 patients diagnosed with CML and who were receiving TKI. They were divided into two groups according to the type of TKI: imatinib and nilotinib. There was no statistically significant difference between study groups in terms of age, gender, prevalence of diabetes, smoking, and baseline laboratory findings with p > 0.05. After completion of 6 months of therapy, the highest incidence of remission was in patients on nilotinib treatment (n = 27, 77.1% versus n = 16, 45.7%) compared to the imatinib group (p = 0.007).

Conclusions

Our findings indicate that nilotinib had greater efficacy compared to imatinib in patients who were newly diagnosed with chronic-phase Philadelphia chromosome-positive CML.