OBJECTIVES: This analysis examined clinical outcomes and drug survival of tirosine kinase inhibitor (TKI) therapy in patients with chronic myeloid Leukemia (CML) in a ten years follow-up using real world data.

METHODS: A retrospective analysis from real-world data was performed from clinical records of a cohort of adult patients living with CML who received TKI during the last ten years. Clinical outcomes were measured by hematological, molecular and genetical response in in two times. Drug survival of imatinib, dasatinib and nilotinib was analized based on dates of start and end of treatments, and whether treatment was maintained at the time of the last visit. Reasons for drug discontinuation was also analized.

RESULTS: Data from 36 patients were included mean age 41(DE±16), 55.2% were women (20/36); hematological response at first time of treatment was achieve in 57.1% (4/7) for dasatinib, 45.8%(11/24) imatinib, 40% (2/5) nilotinib. After 12 months of treatment 20.8% (5/24) of patients treated with imatinib achieves cytogenetic response; in like maner 16% (4/24) with imatinb achieves molecular response. The retention rate of TKI therapy was 69.4% at first year, 33.3% at 5 years and 13.9% at 10 years; Prior to any adjustment, the highest median survival was observed in nilotinib (5.5 years) and the lowest in dasatinib (2.9 years). The most frecuently reason for discontinuation was ineffectiveness 70%, adverse events 20% and non-adherence 10%. After 10 years of treatment 88.2% of patients achieves hematological response, 41.15% achieves mayor cytogenetic response and 55.8% molecular response.

CONCLUSIONS: This 10 year follow-up shows in first line of treatment, dasatinib shows the best rate of hematological response, however also shows the lowest median of survival; the loss of effectiveness is the major reason of discontinuation