Real-World Treatment Outcomes and Safety Profiles of Tyrosine Kinase Inhibitors in Iraqi Patients with Chronic Myeloid Leukemia

Abstract

Objective: To investigates the safety profile and efficacy of tyrosine kinase inhibitors in chronic myeloid leukemia patients in Al-Diwaniyah, with a particular focus on how pre-existing disease history influences adverse events and treatment outcomes. 

Study Design: Descriptive study 
Place and Duration of Study: This study was conducted at the Hematology Center, Diwaniyah Teaching Hospital, Iraq from 1st February 2025 to 30th May 2025. 

Methods: Fifty-one adult patients with Philadelphia chromosome-positive chronic myeloid leukemia, receiving Imatinib, Nilotinib, or Bosutinib were assessed. Clinical response was categorized based on recent BCR-ABL1  transcript levels into complete, major, deep, loss of major, or relapse response. Safety profiles and disease history were evaluated through documented adverse drug reactions and laboratory findings. 

Results: The mean age was 49.5 years with 56.9% males. Imatinib was the most used tyrosine kinase inhibitors (52.9%), followed by Nilotinib and Bosutinib (23.5% each). Imatinib showed the best efficacy with the highest  complete and major molecular response rates and the lowest relapse incidence (29.4%). Nilotinib had similar efficacy and side effects, while Bosutinib showed lower responses and higher hematological toxicity. Most 41 patients reported no adverse effects; 9 experienced toxicities like diarrhea, abdominal pain, joint pain, and hair loss. While 31 had no prior medical history, others had conditions such as diabetes, hypertension, or hypothyroidism. 

Conclusion: The significant differences in tyrosine kinase inhibitors response and safety among Iraqi chronic myeloid leukemia patients, emphasizing the importance of personalized treatment strategies. The findings underscore the need to consider individual patient disease history when selecting tyrosine kinase inhibitors to optimize outcomes and effectively manage adverse events.