Epidemiology of Chronic Myeloid Leukemia in the Republic of Bashkortostan

Background. The planning of therapeutic, diagnostic, and preventive medical care for chronic myeloid leukemia (CML) patients implies the need of not only maintaining patient registries, but also conducting epidemiologic studies in each geographical area. Aim. To study and analyze CML epidemiological indicators over the last 15 years in the Republic of Bashkortostan for the purposes of evaluation and rational planning of specialized medical care for CML patient population. Materials & Methods. The incidence, prevalence, and mortality of CML patients of all age groups in the period of 2000–2016 was analyzed in the Republic of Bashkortostan. Results. The analysis of epidemiological indicators over the period of 2000–2016 showed that the incidence of the disease in the Republic of Bashkortostan was increasing. Within the last 8 years the prevalence rate even quadrupled which is clearly connected with improved detectability of Ph-chromosome and/or BCR-ABL gene, creation and maintenance of CML patient registry since 2008, introduction of treatment using tyrosine kinase inhibitors resulting also in increase in life expectancy. Mortality rates are reported to have a tendency of decrease over the period under study. Conclusion. Key epidemiological indicators of CML in the Republic of Bashkortostan are comparable with the data of international and Russian researchers. The results obtained can be used for comparative studies and improvement of specialized medical care for CML patients

Chronic Myeloid Leukemia Patient Registry in the Russian Federation: From Observational Studies to the Efficacy Evaluation in Clinical Practice

Background. Due to the significant increase in life expectancy and the quality of life in patients with chronic myeloid leukemia (CML) as well as the growing need for expensive tyrosine kinase inhibitors (TKI), the analysis of cost-effectiveness and lifelong monitoring of patients is especially important. Aim. We present the results of a multicenter observational study “The Russian Registry of Chronic Myeloid Leukemia in routine clinical practice (2011–2016)”. Materials & Methods. The study included Russian patients with CML, confirmed by the detection of a Ph-chromosome or a BCR-ABL transcript. The statistical analysis (July 1, 2016) included 7609 patients from 80 regions of the Russian Federation (covering 95 % of the population). The annual increase in the number of patients with newly diagnosed CML was 600–650 patients. At the time of the statistical analysis, 6995 (92 %) patients remained under observation, 473 (6 %) died and 141 (2 %) were withdrawn. The registry included 44 % of men and 56 % of women, the median age was 49 years (range 2–94 years). The peak incidence (46.3 %) occurred at the age of 40–60 years. The median disease duration by the time of the analysis was 6 years (range 0.1–30 years). Results. The disease was diagnosed in the chronic phase (CP), acceleration phase, and blast crisis in 6560 (93.8 %), 380 (5.5 %) and 47 (0.7 %) patients, respectively. The proportion of risk groups according to Sokal for low, intermediate and high risk in CP was 49 %, 30 %, and 21 %, respectively. TKI were administered to 6473 (92.5 %) patients. Imatinib and the second generation TKI (TKI2) were administered to 5570 (86 %) and 903 (14 %) patients, respectively. The total of 30.4 % of patients received the increased imatinib dose of 600–800 mg. In the TKI2 group, 558 (61.7 %) patients received nilotinib and 345 (38.2 %) patients received dasatinib. The proportion of patients with completed molecular genetic studies (MGS) in 2014, 2015 and the first 6 months of 2016 amounted to 61 %, 58 % and 23 %, respectively. The proportion of patients with cytogenetic studies (CS) for the same period was 28 %, 26 % and 7 %, respectively. No CS or MGS data were presented for 34 %, 35 % and 63 % of patients during this period. Optimal molecular response and major molecular response (MMR) for TKI therapy were observed in 23 % and 58 % of patients treated 12 months, respectively. When nilotinib was used in the second line, MMR was obtained in 42 % of patients, and a deep molecular response was obtained in 25 % of patients (BCR-ABL < 0.01 %). Conclusion. The high efficacy of TKI therapy was observed in the majority of patients with the possibility of achieving a minimal residual disease. The problems concerning untimely monitoring and suboptimal administration of second line treatment were identified. In general, the CML patient registry allowed the data integration of data and information management of population with CML in Russia

Serum Immunoglobulins in Patients with Iron Deficiency Anemia

Iron deficiency is a common cause of anemia worldwide. Documentation shows that these patients have impaired immunity and are prone to infections. The aim of this study was to confirm whether serum immunoglobulins change in adult nonpregnant females with iron deficiency anemia. Based on patients’ clinical history, CBC results, and serum ferritin, iron and total iron binding capacity, 45 healthy patients and 45 iron deficiency anemia (hypochrom microcytic) patients were entered into this case–control study. Serum IgG, IgA and IgM were measured in patient and control groups using the nephelometry method. Both of the groups were compared using suitable statistical test. Mean serum values of IgG, IgA and IgM in the patient group were 12.47 ± 7.67, 1.93 ± 0.92 and 1.35 ± 0.90 g/l respectively. Mean serum values for the control group were 12.51 ± 6.85, 2.14 ± 0.88 and 1.49 ± 0.73 g/l respectively. Although serum immunoglobulins were slightly lower in the patient group compared to the control group these differences were not significant with the t test. Our study showed serum immunoglobulin levels did not change in iron deficiency anemia