Clinico-pathological Features and Outcomes in Chronic Phase Chronic Myeloid Leukemia Patients Treated with Hydroxyurea

Objective: To study the clinico-pathological features and major outcomes in patients with chronic myeloidleukemia, chronic phase, treated with hydroxyurea.
Methods: This is a single centre study extending from January1997 to June 2003. Data were retrieved from the patients’ records on predetermined performa and analyzed.Patients were primarily diagnosed on the basis of clinical findings, complete blood counts and leukocyte alkalinephosphate (LAP) scores. Bone marrow/trephine and genetic studies were conducted where appropriate. Patientswere primarily treated with capsule hydroxyurea 30-50/ kg/day.
Results: One hundred and seventy six patients,104 (59%) male and 72 (41%) females were included in the study. The median age at diagnosis was 39 years(range 11 to 66 years). The median delay in diagnosis was 156 days (range 30 to 360 days). Eighty four patients(47.7%) presented with pain/discomfort in the left hypochondrium. The mean hemoglobin, white blood cellcount and platelet counts were 10.3 g/dl, 141,000/UL and 341,000/UL respectively associated with a low LAPscore. Hyper-leucocytosis was observed in 19 (10.7%) cases. LDH values above 1000 ug/l were observed in 38(21.5%) cases and creatinin above 1.5 ug/l in 21 (12%) cases. All patients tested, were positive for Philadelphiachromosome and bcr-abl transcripts. At the close of the study, disease advancement was observed in 76 (43.2%)cases, of which 35 (20%) transformed to acute leukemia. One hundred and forty three patients (81%) were aliveat the close of the study. One hundred and two (58.4%) patients were in chronic phase, 22 (12.5%) in acceleratedphase and 19 (10.7%) in blast crisis. Disease progression remained the major cause of death and was seen in 29(16.4%) patients.
Conclusion: In the study population, CML was observed in a younger age group with significantdelay in definitive diagnosis. Clinico-pathological features and major outcomes, however, appear comparable topublished data.