Clinico-hematological characteristic, lipogram, and some metabolic alteration in chronic phase chronic myeloid leukemia in a patient treated with Tyrosine kinase inhibitor

Abstract

Background
Chronic myeloid leukemia (CML) is distinguished by uncontrolled proliferation of myeloid cells. Tyrosine kinase inhibitors (TKIs) have revolutionized management, yet predictors of early molecular response remain under investigation.


Objective
To evaluate clinico-hematological, metabolic, and inflammatory markers, including lipid profile and triglycerides (TG)/high-density lipoproteins (HDL) ratio, as predictors of major molecular response (MMR) in chronic phase (CP) CML cases treated with TKIs.


Patients and methods
This prospective cross-sectional study enrolled 60 adults with CP CML at Assiut University Hospital (2023–2024). Patients were stratified by MMR status at 6 months. Clinical data, complete blood counts, liver and kidney function tests, fasting glucose, and lipid profiles were collected at baseline, third, and sixth months.


Results

A total of 50 patients achieved MMR, while 10 did not. Age and Charlson comorbidity index were higher in the no-MMR group (
P
<0.05). Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and Mmonocyte-to-neutrophil ratio were significantly lower, while MPV was higher in MMR patients at all-time points (
P
<0.05). The TG/HDL ratio was markedly lower in MMR cases at baseline and follow-up (
P
<0.01), despite comparable total cholesterol, LDL, and HDL. Clinical and radiological parameters, including splenomegaly, hepatomegaly, and Eastern Cooperative Oncology Group Performance Status, were not predictive of MMR.



Conclusion
Elevated neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and TG/HDL ratio are negative predictors of early molecular response in CP CML managed with TKIs. These inflammatory and metabolic markers may guide risk stratification and personalized therapy.