Analysis Of Influencing Factors Of Imatinib In The Treatment Of Chronic Myeloid Leukemia

Objective: To explore the factors influencing the long-term efficacy of first-line imatinib in the treatment of patients with Chronic myeloid Leukemia(CML)and the predictive value of four scoring systems,so as to provide the basis for early prognosis evaluation and treatment selection.Methods: The clinical data of 98 newly diagnosed CML-CP patients in Handan Central Hospital from January 1,2010 to June 30,2019 were retrospectively analyzed,chi-square test and binary Logistic regression were used to analyze the predictive value of age,gender,spleen size,number of primary cells,white blood cell count,platelet count,hemoglobin number,percentage of basophilic cells and other factors on the MMR rate of patients at 12 months;Risk was stratified in 98 patients according to the four scoring systems,and the relationship between the four scoring systems and obtaining the best response to TKI treatment at 3,6 and 12 months was analyzed,as well as the predictive value of the four scoring systems for the non-event survival(EFS)rate;Grouped by chromosomal karyotype abnormalities,the relationship between chromosomal abnormalities and CML progression was analyzed.Results: Logistic regression analysis indicated that there was no statistically significant difference in MMR rate at 12 months after initial diagnosis.Hasford and EUTOS scores were statistically significant for predicting the best response at 3 months;The Sokal,Hasford,and ELTS scores were statistically significant for predicting the best response at 6 months;Hasford and ELTS scores were statistically significant for predicting the best response at 12 months.All four scoring systems could effectively predict patients with EFS.There was an intersection between the low and middle risk groups of Sokal and ELTS scores,the curve of Hasford score was significantly different from that of the low risk group,the middle risk group and the high risk group,and the curve of the middle risk group overlapped with that of the high risk group.EUTOS score could significantly distinguish the difference between the high risk group and the low risk group.Patients with additional chromosomal abnormalities(especially the "primary pathway")in karyotype abnormalities were more likely to develop disease progression.Conclusion: The prognostic evaluation of single factor is not significant,and allthe four scoring systems can predict the prognosis well.The Hasford score has a higher predictive value for the best response,and the EUTOS score can more accurately predict the EFS rate,and patients with additional chromosomal abnormalities are more likely to develop disease progression.