Response to Tyrosine Kinase Inhibitors in Patients with BCR-ABL1 Positive Chronic Myeloid Leukemia; 20 Years’ Experience at Patan Hospital, Nepal

Chronic Myeloid Leukemia (CML) is characterized by a specific genetic anomaly. Imatinib mesylate serves as the primary treatment for CML at Patan Hospital in Nepal which was initiated as compassionate use program under Novartis Pharmaceuticals. In this retrospective 20-year study involving 431 CML patients enrolled in the Max Access Program, it was observed that 64.7% achieved optimal treatment responses, 11.6% had suboptimal outcomes, and 14.6% experienced treatment failure. The survival rate for CML patients was 89.1%. Some patients exhibited genetic mutations like T315I and were subsequently treated with a 3rd generation TKI known as ponatinib. The increased detection of mutations can be attributed to expanded testing practices, aligning with trends observed elsewhere. In summary, the research suggests that TKIs have had a beneficial impact on CML treatment, leading to improved survival rates, on par with those in developed countries.