Baseline Blood Count Levels Increase Odds Of Cytopenia among CML Patients in Kenya: A Case Control Study
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Date
2021
Authors
McLigeyo, Angela
Rajab, Jamila
Oyiro, Peter
Ezzi, Mohammed
Bett, Yatich
Ong'ondi, Matilda
Odhiambo, Andrew
Mwanzi, Sitna
Othieno - Abinya, Nicholas
Journal Title
Journal ISSN
Volume Title
Publisher
Research square
Abstract
Imatinib is the gold standard for the treatment of all phases of Philadelphia positive Chronic Myeloid
Leukemia (CML). During treatment, patients may develop cytopenia. We aimed to study the baseline
characteristics and factors associated with cytopenia at a Nairobi Hospital.
Methods
This was a retrospective case-control study of patients aged ≥ 18 years on follow-up at the Glivec
International Patient Access Program (GIPAP) clinic from 2007–2015. The cases consisted of CML
patients on imatinib who developed cytopenia. The controls were CML patients on imatinib who did not
develop cytopenia. Baseline socio – demographic, clinical, hematologic, and molecular data were
retrieved from patients’ les. Chi square or shers’ exact tests were used to analyze for differences
between cytopenia and no cytopenia. Binary logistic regressions were employed to identify relationships.
Univariate and multivariate analyses were done to identify independent predictors of cytopenia. Odds
ratios (OR) were presented including the 95% condence intervals and respective p values.
Results
A total of 201 patients were studied. Males were 52%, 42% were aged 36–50 years, 70% had symptoms
for > 12 months before diagnosis, 78.6% had B symptoms at baseline, 80% had a moderate
splenomegaly at baseline, 40% and 37.4% developed cytopenia within 3 months and 3–6 months
respectively after imatinib initiation. Baseline neutrophilia, neutropenia, anaemia, thrombocytosis,
thrombocytopenia was found in 68%, 11%, 11%, 23.5% and 11% respectively. Baseline hemoglobin,
neutrophil and platelet level were signicantly different between the cytopenia and the no cytopenia
group. On univariable analysis, baseline anemia with hb < 7.9g/dL (p = 0.002), neutropenia (p = 0.001),
neutrophilia > 100,000/mm3
(p = 0.002) and thrombocytopenia (p = 0.001) increased the odds of
developing cytopenia. On multivariable analysis, baseline anaemia (p value < 0.002), neutropenia (p
value < 0.001), thrombocytopenia (p value, < 0.001) and thrombocytosis (p value, 0.033) increased the
odds of developing cytopenia.
Conclusion
Odds of cytopenia were higher in presence of baseline cytopenia and thrombocytosis. Clinicians should
have a high index of suspicion for these patients.
Description
A research article published in Research Square
Keywords
cytopenia, CML patients, Kenya
Citation
McLigeyo, A., Rajab, J., Oyiro, P., Ezzi, M., Bett, Y., Ong'ondi, M., ... & Othieno-Abinya, N. (2021). Baseline blood count levels increase odds of cytopenia among CML patients in Kenya: a case control study.