CML-307: Assessment of 5-Year OS and Treatment Options in Newly Diagnosed Ph + CML Patients in the Republic of Armenia

Philadelphia-positive (Ph+) chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder characterized by the BCR-ABL1 mutation, resulting from the t(9; 22) (q22; q11) chromosome translocation. In Western countries, the median age at diagnosis of CML is 56–57 years. Treatment with tyrosine kinase inhibitors (TKIs) increases the number of patients with chronic phase (CP) and prolongs overall survival (OS). Compared to the early 1990s, in 2020, globally, TKI provided 91% of the median 5-year OS and 83% of the median 10-year OS. Our purpose is to show the 5-year OS rate during 2010–2015 in the Republic of Armenia (RA) and describe the treatment options and median age at diagnosis during 2010–2020. The data presented for this retrospective analysis was taken from the Armenian CML Register and the Register of Blood Diseases of the Hematology Center aft. Prof. R. Yeolyan. This information has been supplemented by data from the National Oncological Center after V.A. Fanarjyan, as well as data from the death registration service at the Ministry of Justice RA. The number of primary patients with Ph+ CML in 2010–2020 was 192, 100% of whom received TKIs in RA. Armenia has received imatinib from the Max Foundation since 2003. Since nilotinib and ponatinib have only become available in RA starting in 2017, the 5-year OS is mainly linked to the effectiveness of imatinib. Of 192 patients, 88.2% were diagnosed with CP, 8.8% in the accelerated phase (AP), and 3% in the blast phase (BP). 182 patients (95%) received imatinib, of which 152 patients received imatinib at a dose of 400 mg/day, 30 patients at 600 mg/day, and 1 pediatric patient at 300 mg/day. 10 patients (5%) received hydroxycarbamide. 5-year OS for 2010–2015 is 92%. Despite the limited treatment and monitoring opportunities and the younger median age at diagnosis, the 5-year OS rate in Armenia during 2010–2015 is similar to international statistics.