CHRONIC MYELOID LEUKEMIA IN ADOLESCENTS AND YOUNG ADULTS: CLINICOPATHOLOGICAL FEATURES AND OUTCOMES-A CASE SERIES FROM A TERTIARY CARE INSTITUTE

Abstract

Significant advances have been made in the treatment of leukemia over the past two decades. However, the majority of research has concentrated on pediatric and elderly populations, leaving adolescents and young adults, conventionally defined as individuals aged 15–39 years, comparatively underexplored. These demographic faces unique biological, psychosocial, and therapeutic challenge that necessitate tailored management strategies. Despite transformative advances in chronic myeloid leukemia (CML) therapy through tyrosine kinase inhibitors (TKIs), studies specifically focused on adolescents and young adults patients remain limited. A retrospective case series of eight patients aged 16–35 years presenting to the outpatient and inpatient departments of Era University, Lucknow, was conducted. All patients underwent complete blood count with differential leukocyte count, ultrasonography, bone marrow aspiration (BMA), conventional karyotyping, and reverse transcriptase–quantitative polymerase chain reaction (RT-qPCR) for BCR-ABL1 transcript quantification. All eight patients were confirmed to have CML in the chronic phase (CML-CP), with female preponderance (5:3). Prominent clinicopathological features included marked leukocytosis (TLC range: 70,000–3,00,000/μL), anemia, hepatosplenomegaly, and a left-shifted myeloid differential with elevated myeloid-to-erythroid (M:E) ratios (range: 14:1–32:1) on BMA. Philadelphia chromosome positivity and BCR-ABL1 p210 fusion transcript were confirmed in all cases by karyotyping and RT-qPCR, respectively. CML in the adolescents and young adult’s population presents with distinctive clinicopathological features, including greater disease burden at diagnosis compared with older cohorts. A comprehensive understanding of prognostic determinants, treatment adherence challenges, and long-term outcomes in this age group is imperative to optimize therapeutic strategies and improve prognosis.