Chronic Myelogenous Leukemia (CML) at Phramongkutklao Hospital

Abstract

Background: CMI. is one of myeloproliferative diseases which has abnormality of pleurpotent stem cell. The patients usually have problems from excessive growth of granulocytic cell line. Some patients also have thrombocytosis. Objective: To study clinical manifestations of CML in Thai patients and the result of treatment. Method: The study is descriptive and was done by collection
the data of CML patients seen at hematology division, Pramongkulkdao hospital duning 1983-1999. Results: There are 84 CML patients. Fity are male (59 5%) and 34 are female (40.5%). Median age 37.5 years (range, 15-76). The presenting symptoms are fatigue 63.1%, abdominal discomfort 47.6%, fever 23:8%, bleeding 15.5%, soft tissue mass 2.4%. The physical examinations reveal splenomegaly 90.5%, anemia 67.9%, hepatomegaly 59.5% fever 21.4% and kmphadenopathy 16.7%. Investigations show mean hemoglobin 9 522.6 gm/dl, WBC 250,987+189,190/11, platelet 425,55591287,767/11. A11 bone marrow specimens are hepercellular. Cytogenetic studies show Philadelphia chromosome 87.3%. At diagnosis, the patients are in chronic phase 57.1%, accelerated phase 21.4% and blastic phase 21.4%. The treatments consist of hydroxyurea, busulfan, interferon Q, AraC + 6TG, AraC +
Adhamycin or Mitoxantrone. There are 14 patients (16.7%) receiving splenic iradiation for painful splenomegaly. At the time of analysis, 11 patients (13.1%) are alive, 32 patients (38.1%) lost to follow-up and 41 patients (48.9%) are dead. The most common cause of death is infection. Overall median survival is 37:02 months. Conclusion: CML is not uncommon at Pramongkulkdao hospital. Early diagnosis and new treatment such as stem cell transplantation can improve survival of these patients.