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 myeloid leukemia, chronic phase, treated with hydroxyurea.

Methods: This is a single centre study extending from January 1997 to June 2003. Data were retrieved from the patients' records on predetermined performance and analyzed. Patients were primarily diagnosed on the basis of clinical findings, complete blood counts and leukocyte alkaline phosphate (LAP) scores. Bone marrow/trephine and genetic studies were conducted where appropriate. Patients were 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 cell count and platelet counts were 10.3 g/dl, 141,000/UL and 341,000/UL respectively associated with a low LAP score. Hyper-leucocytosis was observed in 19 (10.7%) cases. LDH values above 1,000 ug/l were observed in 38 (21.5%) cases and creatinine above 1.5 ug/l in 21 (12%) cases. All patients tested, were positive for Philadelphia chromosome 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 alive at the close of the study. One hundred and two (58.4%) patients were in chronic phase, 22 (12.5%) in accelerated phase 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 significant delay in definitive diagnosis. Clinico-pathological features and major outcomes, however, appear comparable to published data.