Published: 2020-11-23

Study of demographic, hematological profile and risk stratification in chronic myeloid leukemia patients, in and around North-West Punjab, India

Rajandeep Kaur, Rajeev Gupta, Manish Chandey, Parminder Singh, Gurinder Mohan, Navdeep Singh, Shveta Mahajan, Robin Kamboj


Background: Chronic myeloid leukemia (CML) is a hematopoietic stem cell disorder with cytogenic profile and tyrosine kinase inhibitors used as its therapy. Objective of the present study was to determine the demographic, haematological profile and to characterize them in low and high-risk group on presentation with European treatment and outcome study score (EUTOS) in CML patients in and around North-West Punjab, India.

Methods: Diagnosed cases of CML were taken. Investigations were done. Molecular and cytogenetic studies were also done whenever required and with EUTOS patients were stratified and then treatment was individualized.

Results: Total 100 patients were enrolled. The mean age of presentation of CML was 44.7 years with M:F ratio was 1:1. 20% cases were of Hindu religion and 80% cases were Sikh by religion. 68% cases from rural area and 32% cases were from urban area. 92 patients were in chronic phase, 5 patients in accelerated phase, and 3 patients were found in blast crisis phase. Out of total 100 cases, 32% cases were of high-risk group and 68% cases were of low-risk group on presentation according to EUTOS.

Conclusions: Most CML patients in north west Punjab are young (31-40 years) with male: female ratio is 1:1. Majority of them were Sikh by religion and from rural area. Most of them presented in Chronic phase of the disease and with low-risk strata according to EUTOS. Conclusion is that most patients presents in early phase of disease, with anaemia, leucocytosis or splenomegaly.


Accelerated phase, Blast crisis, Chronic phase, Chronic myeloid leukaemia, European treatment and outcome study score

Full Text:



Rowley JD. A new consistent chromosomal abnormality in chronic myelogenous leukaemia identified by quinacrine fluorescence and Giemsa staining. Nature. 1973;243(5405):290-3.

Groffen J, Stephenson JR, Heisterkamp N, de Klein A, Bartram CR, Grosveld G. Philadelphia chromosomal breakpoints are clustered within a limited region, bcr, on chromosome 22. Cell. 1984;36(1):93-9.

Lugo TG, Pendergast AM, Muller AJ, Witte ON. Tyrosine kinase activity and transformation potency of bcr-abl oncogene products. Science. 1990;247(4946):1079-82.

Perrotti D, Calabretta B. The biology of CML blast crisis. Blood. 2004;103:4010-22.

Au WY, Caguioa PB, Chuah C, Hsu SC, Jootar S, Kim DW, et al. Chronic myeloid leukemia in Asia. Int J Hematol. 2009;89(1):14-23.

Druker BJ, Guilhot F, O'Brien SG, Gathmann I, Kantarjian H, Gattermann N, et al. Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. N Eng J Medic. 2006;355(23):2408-17.

Hughes TP, Kaeda J, Branford S, Rudzki Z, Hochhaus A, Hensley ML, et al. Frequency of major molecular responses to imatinib or interferon alfa plus cytarabine in newly diagnosed chronic myeloid leukemia. N Eng J Medic. 2003;349(15):1423-32.

Singhal MK, Sengar M, Nair R. Summary of the published Indian data on chronic myeloid leukemia. So As J Canc. 2016;5(3):162.

Deshmukh C, Saikia T, Bakshi A, Amare-Kadam P, Baisane C, Parikh P. Imatinib mesylate in chronic myeloid leukemia: a prospective, single arm, non randomized study. J Assoc Physic Ind. 2005;53:291-5

Ahmed R, Naqi N, Hussain I, Khattak BK, Nadeem M, Iqbal J. Presentating phases of chronic myeloid leukaemia. J Coll Physicians Surg Pak. 2009;19(8):469-72.

Tardieu S, Brun‐Strang C, Berthaud P, Michallet M, Guilhot F, Rousselot P, et al. Management of chronic myeloid leukemia in France: a multicentered cross‐sectional study on 538 patients. Pharmacoepidemiol Drug Saf. 2005;14(8):545-53.

Ganesan P, Kumar L. Chronic myeloid leukemia in India. J Glob Oncol. 2017;3(1):64-71.

Kumar S, Gupta VK, Bharti A, Meena LP, Gupta V, Shukla J. A study to determine the clinical, hematological, cytogenetic, and molecular profile in CML patient in and around Eastern UP, India. J Fam Medic Prim Ca. 2019;8(7):2450.

Singh G, Parmar P, Kataria SP, Singh S, Sen R. Spectrum of acute and chronic leukemia at a tertiary care hospital, Haryana, India. Int J Res Med Sci. 2016;4:1115-8.

Chang F, Qazi RA, Khan M, Baloch S, Sahito MM, Mir A. Clinico hematological profile and phase distribution of chronic myeloid leukemia. Biolo Medic. 2015;7(5):1.

Khaled SA, Abd El Aziz NM. Demographic, clinical, and hematologic characteristics of patients with chronic myeloid leukemia in Upper Egypt: association with treatment responses. Egypt J Haematol. 2015;40(4):195.

Bhatti FA, Ahmed S, Ali N. Clinical and hematological features of 335 patients of chronic myelogenous leukemia diagnosed at single centre in northern Pakistan. Clinical medicine. Blood Disor. 2012;5:CMBD-S10578.