Survival with Chronic Myelogenous Leukemia

Ahmet Özet, MD, Department of Medical Oncology, Gulhane Military Medical Academy, TR-06018 Ankara (Turkey), Fax 0090-312-321 77 78 The median survival time after diagnosis with conventional therapy and routine supportive care is 3-4 years in patients with chronic myelogenous leukemia (CML) [1]. Galimberti et al. [2] reported that the actuarial probabilities of survival and relapse-free survival at 82 months were 71 % of 24 patients who had undergone allogenic bone marrow transplantation in the chronic phase following a preparation with busulphan and cyclophosphamide. Another study concluded that interferon-a (INF-a) therapy improves survival compared to classical treatments (median 62 vs. 39 months) [3]. Several studies have shown that INF-a may prolong the survival time. Philadelphia chromosome-negative patients respond less favorably to therapy. In addition the sites of the break of chromosome 22 affect the prognosis. The break in the 5’ region was indicative of a long survival (17 years) in a patient with CML after therapy for Hodgkin’s disease in 1994. We report a 67-year-old male patient with CML who has been alive for 197 months after diagnosis on treatment. We made the diagnosis with a peripheral blood smear and bone marrow examination in 1980. The peripheral blood smear showed a moderate increase in the white blood cell count, rare blast cells, normochromic normocyte anemia and bone marrow examination revealed hypercellularity with marked proliferation of all granulocytic elements and mild fibrosis. The leukocyte alkalone phosphate level was low, the uric acid level was elevated and the Philadelphia chromosome was positive at the time of diagnosis. The initial therapy was performed with busulfan in conventional doses and intervals and continued until May 1994. We tried to use INF-a but unfortunately this therapy had References Kanterjian HM, Deisseroth A, Kurzrock R, Estrov Z, Talpaz M: Chronic myelogenous leukemia: A concise update. Blood 1993;82:691. Galimberti M, Polchi P, Lucarelli G, Angelucci E, Baronciani D, Giardini C, Gaziev D, Erer B, Ripalti M, Rapa S, et al: Allogenic marrow transplantation in patients with chronic myelogenous leukemia in chronic phase following preparation with busulfan and cyclophosphamide. Bone Marrow Transplant 1994; 13/2: 197-201.