Unveiling Current Trends in Clinical Features and Assessing Induction Outcomes in Chronic Myeloid Leukemia (CML): A Multicenter Retrospective Analysis in Palestine رسالة ماجستير

Abstract

Background: Chronic Myeloid Leukemia (CML) is a hematologic malignancy characterized by the BCR-ABL1 fusion gene, resulting from the Philadelphia chromosome translocation. While treatment with tyrosine kinase inhibitors (TKIs) has significantly improved outcomes globally, limited data are available regarding the clinical characteristics and treatment responses of CML patients in Palestine. Objective: This study aimed to evaluate the clinical features, induction treatment outcomes, and prognostic factors affecting response among Palestinian patients diagnosed with CML. Methods: A retrospective multicenter study was conducted on 85 CML patients treated between 2018 and 2023 at An-Najah National University Hospital and Watani Hospital in Nablus. Clinical, laboratory, and treatment-related data were extracted from electronic medical records. Treatment responses were assessed based on European LeukemiaNet (ELN) 2020 criteria. Statistical analysis was performed using SPSS version 21. Results: The mean age of patients was 47.6 years, with a male-to-female ratio of 1.24:1. The most frequent presenting symptoms were fatigue and bone pain (51.8%), weight loss (41.2%), and splenomegaly (38.8%). The majority of patients (95.3%) were diagnosed during the chronic phase. A complete hematologic response (CHR) was achieved in 82.4% of cases, while major molecular response (MMR) was observed in 58.8%. Clinical features such as fever, weight loss, and splenomegaly were significantly associated with poorer treatment response (p < 0.05), whereas age, gender, and baseline hematological parameters showed no significant impact. Conclusion: CML in Palestine is more commonly diagnosed in middle-aged males and typically during the chronic phase. Most patients demonstrate favorable hematologic and molecular responses to first-line TKI therapy. However, certain clinical signs at diagnosis— namely fever, weight loss, and splenomegaly—are associated with suboptimal response, highlighting the importance of early detection and individualized treatment strategies