{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:25:26Z","timestamp":1787757926486,"version":"build-2784847793"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T00:00:00Z","timestamp":1650931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objective:<\/jats:title>\n                    <jats:p>Clinical, laboratory and outcome data were reviewed for pediatric patients who were diagnosed with chronic myeloid leukemia (CML) and managed at two tertiary care hospitals in Saudi Arabia, between January 2011 and December 2017 to assess the response to tyrosine kinase inhibitors (TKI) focusing on the monitoring of BCR-ABL fusion gene transcript levels and to look at the overall outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>CML patients were identified based on the cytogenetic and molecular results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twelve pediatric patients diagnosed with CML at a median age of 8.4 year; treated with TKI as first-line therapy, 11 (91.7%) patients were started with imatinib (first-generation TKI), while one received dasatinib (second-generation TKI) due to his three-way Philadelphia chromosome sensitivity. Eight patients (72.7%) starting on imatinib were switched to dasatinib (six patients due to drug resistance, and two patients due to intolerance of Imatinib) and two patients (25%) of whom had already achieved major molecular response (MMR) on Imatinib. Response rate to imatinib in terms of achieving MMR as first-line therapy was achieved in five out of 11 patients (45.5%) and only three of them continued to maintain their MMR. Six out of eight patients who were switched to dasatinib achieved MMR. Two patients underwent hematopoietic stem cell transplant (SCT): one due to blast crisis and one due to the side effects of TKI. With a median follow-up time of 78 months (range, 40.5\u2013108), all of our patients were alive at last update.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We report an excellent outcome with an overall survival (OS) of 100% at 5-year and disease- free survival (DFS) of 91.7% (8.0%). All our patients achieved MMR and only one patient had loss of MMR on follow-up. Eight patients (66.7%) achieved complete molecular response (CMR).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijpam.2022.04.001","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T17:15:16Z","timestamp":1654190116000},"page":"160-164","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Outcome of pediatric chronic myeloid leukemia with management focusing on the monitoring of BCR-ABL fusion gene transcript levels"],"prefix":"10.4103","volume":"9","author":[{"given":"Ibrahim","family":"Al-Ghemlas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad","family":"Al-Daama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawazin","family":"Aqueel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khawar","family":"Siddiqui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"El-Solh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala","family":"Omer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loloah","family":"AlRajeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Al-Seraihy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Alahmari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawazen","family":"AlSaedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awatif","family":"AlAnazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouhab","family":"Ayas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-2-20240903","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1542\/peds.2004-2473","article-title":"Clinical and biological features at diagnosis in 40 children with chronic myeloid leukemia","volume":"116","author":"Millot","year":"2005","journal-title":"Pediatrics"},{"key":"R2-2-20240903","first-page":"765","article-title":"Chronic leukemias of childhood","volume":"35","author":"Altman","year":"1988","journal-title":"Pediatr Clin"},{"key":"R3-2-20240903","first-page":"33","article-title":"Managing children with chronic myeloid leukaemia (CML): recommendations for the management of CML in children and young people up to the age of 18 years","volume":"167","author":"de","year":"2014","journal-title":"BrJHaematol"},{"key":"R4-2-20240903","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1200\/JCO.2003.11.143","article-title":"Practical management of patients with chronic myeloid leukemia receiving imatinib","volume":"21","author":"Deininger","year":"2003","journal-title":"J Clin Oncol"},{"key":"R5-2-20240903","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.blre.2005.01.008","article-title":"Molecular monitoring of BCR-ABL as a guide to clinical management in chronic myeloid leukaemia","volume":"20","author":"Hughes","year":"2006","journal-title":"Blood Rev"},{"key":"R6-2-20240903","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1001\/jamaoncol.2015.50","article-title":"Imatinib-A new tyrosine kinase inhibitor for first-line treatment of chronic myeloid leukemia in 2015","volume":"1","author":"Gambacorti-Passerini","year":"2015","journal-title":"JAMA Oncol"},{"key":"R7-2-20240903","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1038\/s41375-018-0179-9","article-title":"Front-line imatinib treatment in children and adolescents with chronic myeloid leukemia: results from a phase III trial","volume":"32","author":"Suttorp","year":"2018","journal-title":"Leukemia"},{"key":"R8-2-20240903","first-page":"640","article-title":"Implementation of management guidelines for chronic myeloid leukemia: perspectives in the United States","volume":"37","author":"Rizzieri","year":"2012","journal-title":"P T"},{"key":"R9-2-20240903","doi-asserted-by":"crossref","first-page":"2292","DOI":"10.1182\/blood-2002-04-1199","article-title":"The World Health Organization (WHO) classification of the myeloid neoplasms","volume":"100","author":"Vardiman","year":"2002","journal-title":"Blood"},{"key":"R10-2-20240903","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1182\/asheducation-2018.1.168","article-title":"Molecular monitoring in CML: how deep? 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