Abstract
Chronic myeloid leukemia (CML) in childhood is rare accounting
for less than 10 % of all cases of CML and less than 3% of all
pediatric leukemia. We conducted a retrospective study of
children and young adults (CYA) with CML diagnosed in Tunisia from June
2003 through December 2022. Diagnosis of CML was confirmed by RT-PCR for
all patients. Data were analyzed regarding epidemiological
characteristics, clinical presentations, molecular findings, treatment
response and side effects of Tyrosine kinase inhibitors (TKI).
Of the 1876 patients diagnosed with CML during this period 61
(3.25%) were under 18 years. 37 were male and 24 were female. The
chronic phase (CP) was the most common phase of CML seen in 43 patients.
While 9 patients were in accelerated phase (AP) and 9 had inaugural
blast crisis. Mean white blood cell count were 232 x10
9 /L. All patients were positive for bcr-abl
transcript : 32 patients had b2a2, 25 had b3a2. They were given oral
TKI. Only 5 patients underwent hematopoietic stem cell transplantation.
51 achieved complete hematologic remission on imatinib. 27 patients
achieved major molecular remission and 13 are currently maintaining a
bcr-abl ratio under 0.01% which corresponds to MR4.5
,6 patients progressed under TKI within 7 months. This
retrospective study represents the first series of CYA with CML in
Africa. Our data are comparable with the literature findings regarding
epidemiological characteristic, clinical presentations, and response to
TKI.
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