TYPES OF ANEMIA IN PATIENTS WITH CHRONIC MYELOID LEUKEMIA-CHRONIC PHASE ON IMATINIB MESYLATE

H Mohammed, Abdulsalam

	TYPES OF ANEMIA IN PATIENTS WITH CHRONIC MYELOID LEUKEMIA-CHRONIC PHASE ON IMATINIB MESYLATE
IRAQI JOURNALOF COMMUNITY MEDICINE
Article 1, Volume 25, Issue 1, 2012, Pages 19-22
Author
Abdulsalam H Mohammed
Abstract
Background: Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of pluripotent hemopoietic stem cells, resulting from t(9;22)(q34;q11) producing Bcr-Abl1 fusion transcript. Imatinib mesylate is a specific Bcr-Abl tyrosine kinase inhibitor which is well tolerated but may cause a myelosuppression which results in treatment interruptions and poor outcome. Aim of the study: To evaluate the types of anemia in patients with CML-chronic phase on imatinib mesylate. Patients and methods: This is a cohort prospective study which included 200 patients with CML-chronic phase attending the National Center for Hematology from October 2009 to April 2010. These patients are already on imatinib mesylate and having documented normal hemoglobin (Hb) concentration and/or packed cell volume (PCV) % at time of diagnosis. Results: Male:female ratios are 1:2, 1:1 and 1.04:1 for iron deficiency anemia, megaloblastic anemia and anemia of chronic disorder respectively, Out of the total 200 patients enrolled in this study, 59 patients (29.5%) were having anemia, 43 patients (21.5%) with anemia of chronic disorder and 16 patients (8%) with nutritional anemia divided into 12 patients (6%) with iron deficiency anemia and 4 patients (2%) with megaloblastic anemia, Forty two patients were having mild anemia, 13 patients with moderate anemia and only 4 patients were facing severe anemia There was non-significant difference in the degree of anemia, evaluated by Hb concentration and PCV % with p-value 0.294 and 0.712 respectively, between iron deficiency anemia, megaloblastic anemia and anemia of chronic disorder. Conclusions: Incidence of anemia in CML patients is not affected by sex, except for iron deficiency anemia which is more prevalent in menstruating females. The incidence of anemia of chronic disorder is expectedly high because its preventive and therapeutic measure which is the administration of erythropoietin is usually not available. The incidence of both types of nutritional anemia, iron deficiency and megaloblastic, are unacceptable due to the facts that the treatment is available and these patients are already under close follow up, so early diagnosis and treatment of this anemia should be an easy routine. The percentage of severe anemia is within the accepted limits.

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