The treatment of childhood and adolescent chronic myeloid leukaemia in Nigeria

Introduction: The introduction of the tyrosine kinase inhibitors (TKI) has significantly improved the overall survival of Nigerian patients with chronic myeloid leukemia (CML). However, there have been concerns that the outcome for children and adolescents may be sub-optimal.Objectives: To determine the overall survival (OS) of childhood and adolescent CML patients in Nigeria.Methods: We retrospectively examined our records from 2003 to 2011, and identified all Ph+ or BCR-ABL1+ CML patients a‰¤ 18 years at diagnosis, and retrieved their clinical, haematological and biochemical parameters. They received imatinib at 260-340 mg/m2/day. Statistical analysis was done using SPSS 17, and survival studies using the Kaplan-Meier technique.Results: Of the 410 patients diagnosed, 14 (3.4%; male/female = 5/9) paediatric cases were recorded, with a median age of 16.5 (range, 11 - 18) years. At presentation, nine and five patients respectively were in chronic and accelerated phases. As at April 2012, seven patients are known to be alive, one lost to follow-up and six dead from progressive disease. Overall survival at 1 and 2 years were 90% and 79% respectively; while estimated median survival is 48.2 months (95%CI = 42.3 - 54.1). Conclusions: Imatinib continues to deliver impressive survival outcomes in Nigerian patients with CML. As compared to our previously reported data comprising mostly of adults, this cohort seems to suggest that survival outcomes are comparable in paediatric CML cases.