الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Since the eve of the second millennium CML has been the paradigm in using targeted therapy in malignant disorders through the introduction of TKIs and their success paved the road for using the same strategy in other malignancies either hematological or solid with various rates of efficacy & potency but CML remains the most successful story till now.This changed the goals of managing CML and currently we are aiming for TFR instead of just stabilizing the patient, but achieving such a goal requires meticulous criteria and sustained responses which are often subjected to change in the way of when to achieve and how long to maintain this response before deciding which TKI to start, when to shift and when to try stoppage.The risk scores are the most potent prognostic marker in CML but in order to cope with the concept of evolving treatment goals a more dynamic prognostic model is needed to assess our patients.The risk scores are the most potent prognostic marker in CML but in order to cope with the concept of evolving treatment goals a more dynamic prognostic model is needed to assess our patients.Using the kinetics of QPCR decrease is offering an alternative way in assessing our patients either those in optimal or suboptimal responses and new standardized cut-off values are required for the RR & HT in order to replace the static EMR and other pre-defined milestones which will open the door for personalized CML therapy. Achievement of MMR (MR3) at 12 months was associated with attaining EMR at 3 months, MMR was positive in 64.7% versus 33.3% in patients who had EMR versus those who were EMR negative while No MMR was found in 35.3% Vs 66.7% for the same groups respectively, however this was not statistically significant (P=0.131). Achievement of MMR (MR3) at 12 months was also associated with 3 months HT≤ 19 days, MMR was positive in 73.3% Vs 46.7% in patients whose HT ≤ 19 days versus those who were > 19 while No MMR was found in 26.7% Vs 53.3% for the same groups respectively, this was statistically significant (P=0.035).Achievement of MMR (MR3) at 12 months was also associated with 3 months RR≥ 0.11, MMR was positive in 73.8% Vs 26.2% in patients whose RR≥ 0.11versus those who were < 0.11 while No MMR was found in 27.8% Vs 27.2% for the same groups respectively, this was statistically significant (P=0.0001).EFS was correlated with EMR, HT and RR in a positive manner with EFS was met in 51 patients who achieved EMR (37 were censored) Vs event in the form of treatment failure in 4 who didn’t achieve EMR (5 were censored) which was not statistically significant (P=0.208).EFS was met in 30 patients who achieved HT ≤ 19 days (24 were censored) Vs 30 patients who had HT > 19 days (18 were censored) which was better than EMR, but still not statistically significant (P=0.088). EFS was met in 42 patients who achieved RR ≥ 0.11 (34 were censored) Vs 18 patients who had RR 0.11 (8 were censored) which was statistically significant (P=0.002) In order to integrate predictors of QPRC decrease kinetics into guidelines of CML management, more studies are required with larger and more committed subjects to assess the efficacy and potency of such techniques and to have a consensus about the required value for assessing response.