Epidemiological, Clinical, Biological and Therapeutic Characteristics of Myeloproliferative Neoplasms in Eastern Morocco - Abstract
Background: Myeloproliferative neoplasms (MPN) are the most common myeloid neoplasms in Eastern Morocco. The aim of this study is to determine the epidemiological, clinical, biological and therapeutic characteristics of MPN in this region.
Methods: Retrospective descriptive study of patients diagnosed with MPN between January 2008 and December 2012 in two centres in Eastern Morocco. The diagnosis was based mainly on clinical features, blood counts, peripheral blood films and morphology review of bone marrow aspirate and biopsy. Genetic analyses were included whenever available.
Results: Among the 84 cases of MPN registered in Eastern Morocco, chronic myeloid leukemia (CML) was the most frequent accounting for 78.6% of all MPN, followed respectively by primary myelofibrosis (PMF) with 8.3%, polycythemia vera (PV) with 7.1%, essential thrombocythemia (ET) with 4.8% and chronic eosinophilic leukemia (CEL) with 1.2%. Unlike Western countries, CML in Eastern Morocco affects younger populations, and a higher percentage of patients were diagnosed at late stages (12% with accelerated phase and 32% with blast phase). Moreover, to confirm the diagnosis of CML, the detection of the Philadelphia chromosome and the BCR-ABL1 fusion gene were carried out in only a minority of patients (33% and 6% of cases respectively). Only 23% of patients received treatment with the tyrosine kinase inhibitor (TKI) Imatinib. In addition, none of the patients in our series received the second or third generation TKIs treatment or hematopoietic stem cell transplantation. Analysis of the most commonly recognized mutation in BCR-ABL1 negative MPN (JAK2 V617F) was carried out in only 16.7%, 25% and 42.9% of cases of PV, ET and PMF, respectively.
Conclusions: For the majority of patients with MPN, the disease is diagnosed at an advanced stage. In addition, the diagnostic resources are insufficient and need to be developed, particularly cytogenetic and gene mutations analysis. Our results justify the need to establish an effective program aiming at the control of the various subtypes of MPN amongst Eastern Moroccan population.