Bone Marrow Puncture Monitoring of Chronic Myeloid Leukemia

During Treatment with Imatinib; Report Fourth Cases

Khodimatur Rofiah*, Susanto Nugroho*

*Pediatric Resident Faculty of Medicine, Brawijaya University, Saiful Anwar General Hospital, Malang, East
Java, Indonesia

*Hematology Division Pediatric Departement, Saiful Anwar General Hospital, University of Brawijaya, Malang,
East Java, Indonesia

Abstract
Introduction: Imatinib (Gleevec) is a selective BCR-ABL1 kinase inhibitor and a first-line
therapy for the treatment of chronic myeloid leukemia (CML). We describe BMP test result
of four cases of CML who were diagnosed BCR-ABL positive and treated with Gleevec
400mg/day in Pediatric ward Saiful Anwar Hospital, Malang, East Java.
Case presentation: four cases; case one was a 14-years old male on 8 months treatment, case
two was a 13-years old male treated for 6 months, case three was a 14-years old male treated
for one year, and case four was a 12-years old female had been treated during one month. The
blood smear test showed the level of leukosit and trombosit of the four patients became
normal. Mieloblas based on the bone marrow test, case one presented the level of activity
decrease to 3%, case two and three presented the decreased of a high level of activity to
became normal. Case four had been still in the shortest therapy duration.
Conclusions: the duration of follow up of these four patients response showed the efficacy of
Gleevec. There was a steady decrease in the number of leukosit and trombosit to the normal
level of every patient . One patient was in a partial remision CML, two were completed
remision, and one was in the chronic phase.
Keywords: CML, BCR-ABL, Gleevec, BMP evaluation