Survie des Patients Atteints de Leucémie Myéloïde Chronique sous Traitement par Imatinib à Yaounde

Bernard Chetcha Chemegni, MC Nlend Nlend, PA Ngock Dime, P Ndom

Abstract


Dans cette étude, nous reportons la survie des patients atteints de leucemie myeloide chronique sous traitement par imatinib, à yaounde. 81 patients ont été inclus. L’âge de nos patients variait entre 15 et 71 ans avec une moyenne de 39,15 ans. La tranche d’âge 21-40 ans était la plus représentée avec un sex-ratio de 1,18 en faveur des hommes. Les patients originaires de la région de l’Ouest et du Nord-ouest Cameroun étaient les plus représentées avec les pourcentages de 54,32% et 14,81% respectivement.
Au moment du diagnostic 79% des patients étaient en phase chronique de la LMC, 9,8% en phase d’accélération et 11,1% en phase de transformation aigue. La splénomégalie était le principal symptôme. Le risque relatif corrélé a l’indice de SOKAL était respectivement faible chez 30,9% des patients, intermédiaire 23,4% et élevé chez 45,7%. La réponse hématologique complète (RHC) a été obtenue chez 95,06% des patients. Les effets indésirables étaient en général bénins (grade 1 et 2). Les toxicités de grade 3 et 4 étaient rares et réversibles lors d’une interruption temporaire du médicament. La survie globale de 05 ans était de 83%. La survie maximale était de 145 mois. A 24 mois, la survie sans progression était de 80,4%. La survie sans évènement a 5 ans 83,3%. La phase de la maladie influençait la survie globale (p = 0,00009). Le score de SOKAL a également été isole comme facteur pronostic (p = 0,01).

ABSTRACT
In this study, we report the survival of patients with chronic myeloid leukemia treated wit imatinib at Yaounde.A total of 81 patients was included. The age of our patients ranged from 15 to 71 years with a men of 39.15 years. The age group 21-40 years was the most represented. The sex ratio was 1.18 in favor of men. Patients from the of West and North West regions were the most represented with percentages of 54.32% respectively. On diagnosis, 79% of our patient were in chronic phase CML, 9.8% in accelerated phase and 11.1% in acute phase. Splenomegaly was the main symptom. Relative risk correlated with Sokal index was respectively 30.9% lower among patients, inertmediate 23.4% and 45.7% high. The complete hematolgic resp[onse CHR) was achieved in 95.06% patients. Adverse effects were generally mild (grade 1 and 2). Grade 3 and 4 toxicity were rare and reversible during temporal interruption of the drug.
Overall survival at 05 years was 83.3%. The maximum survival was 145 months. At 24 months, progressin-free survival was 80.4%. Event-free survival at 5 years was 83.3%. The phase of the disease had an influence on overall survival (p=0.00009). Sokal score was also isolated as a prognostic factor (p=0.01).


Keywords


Survie, LMC, traitement, Imatinib, Yaoundé.

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