Chronic myeloid leukemia in young patients: Experience in a clinical hematology unit in Senegal

Purpose: As far as we know, there is not yet any study available about chronic myeloid leukemia in children and adolescents in sub-Saharan Africa. In order to describe its clinical, cytogenetic, prognostic, and evolving characteristics, we conducted a retrospective descriptive study during 6 years (February 2008-July 2014). Method: This study was conducted in the Hematology Clinical Unit of the Aristide Le Dantec Hospital (Senegal) involving patients aged 17 years or more, suffering from chronic myeloid leukemia, treated using Imatinib Mesylate. Results: Nine of the 87 patients (10.4%) were included in the study. These were 7 boys and 2 girls, whose median age was 14 years [9-17 years]. They were received in either the chronic phase (7 cases) or the accelerated phase (2 cases). The median diagnostic delay was 19 months [2-54 months]. The Sokal score was low (4 cases), intermediate (3 cases) and high (2 cases). One patient had also a trisomy 8. The overall trend was marked by a complete cytogenetic remission in 6 cases, a partial remission in 2 cases and a minor remission in the remaining case. Two patients lost the response to the treatment, with a mutation of BCR-Abelson objectified in 1 case. Toxic effects were vomiting (1 case), diffuse depigmentation (1 case) and thrombocytopenia (2 cases). Conclusion: In our study, chronic myeloid leukemia in children and adolescents is uncommon and is diagnosed late. Imatinib Mesylate is effective, but the loss of response related to mutations, required the use of other tyrosine kinase inhibitors and/or bone marrow transplantation, which are not available in our regions.