Acompanhamento farmacoterapêutico dos pacientes com leucemia mieloide crônica em uso de mesilato de imatinibe na universidade federal do ceará

Abstract

Chronic myeloid leukemia (CML) is a genetic disorder of unknown etiology characterized by increased and unregulated growth of myeloid precursor cells in the bone marrow. CML is associated with a characteristic chromosomal translocation known as the Philadelphia chromosome. This is a descriptive observational study of CML patients in the Walter Cantídio University Hospital, Federal University of Ceará, Brazil. The aim of the study was to investigate the efficacy and common side effects of imatinib mesylate therapy. Twenty-six patients were included in the study: 9 in the chronic phase (34.61%), 6 in the accelerated phase (23.08%) and 11 in blast crises (42.31%). The cases in the chronic phase had previous intolerance to interferon alpha (IFN-α). Complete hematological responses were observed in 7 patients: 5 in the chronic phase, 1 in the accelerated phase and 1 in blast crisis. During the first year of treatment, 4 patients in the chronic phase presented complete cytogenetic responses. One of these patients subsequently lost response. No patient in the accelerated phase or blast crisis showed complete cytogenetic response. Complete molecular response was confirmed in 1 patient in the chronic phase. Among the 18 patients who were alive at the end of the study, only 4 patients (22.22%) had no complaint. The most commonly reported adverse events were: edema (50%), adynamia (33.33%), bone and/or joint pain (33.33%), headaches (27.78%), cramps (16,67%), diarrhea (16.67%), insomnia (16.67%), itching (16.67%), ecchymosis (11.11%), nauseas (11.11%), epigastric pain (5.55%), erythema (5.55%), shedding of tears (5.55%), dehydration of the skin and lips (5.55%), rush (5.55%), and sweating (5.55%). A minority of patients evolved with imatinib resistance. Newer drugs and trials are being developed to overcome resistance and to increase responsiveness to tyrosine-kinase inhibitors.