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Background In Mexico, patients with hematologic malignancies (HMs) are characterized by being at high risk and advanced stages at diagnosis and by having a low cure rate; yet information on their experiences with health care and health-related quality of life (HRQL) is scarce. We aimed to evaluate experiences with health care and HRQL of patients with HMs and the association between these patient-reported measures. Methods We conducted a cross-sectional survey in two public oncology hospitals in Mexico City. The study included outpatient cancer patients aged ≥18 years with a diagnosis of leukemia, lymphoma, or multiple myeloma. We used a patient-centered quality of cancer care questionnaire to assess patient experiences with receiving 1) timely care; 2) clear information; 3) information for treatment decision-making; 4) care to address biopsychosocial needs; and 5) respectful and coordinated care. We applied the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) to measure HRQL. We performed a multiple linear regression to evaluate the association between patient-reported experiences (independent variables) and the QLQ-C30 summary score (dependent variable). Results Of the 515 participating HM patients, 46.6% had lymphoma, 34% leukemia, and 19.4% multiple myeloma; 70.9% were at advanced stages or at high risk. Additionally, 15.1% had anxiety and 12.8% had depression. Over one third (35.9%) reported receiving clear information, 28.5% timely care, 20.6% information for treatment decision-making, 23.7% care that addressed their biopsychosocial needs, and 31% respectful and coordinated care. The mean QLQ-C30 summary score was 71.9 points. Timely care, clear information, and care that addresses biopsychosocial needs were associated with higher HRQL. Conclusions Health care services for HM patients at public oncology hospitals in Mexico need improvement. Notably, providing timely care, clear information, and care that addresses patients’ biopsychosocial needs can increase the likelihood of better HRQL. Health care providers should measure and improve the experiences of HM patients with health care.

COVID-19 is highly contagious; since it was first identified, the virus has rapidly spread to more than 100 countries and was declared a pandemic on March 11, 2020, by the World Health Organization (WHO). This disease presents several challenges when managing patients with leukemia. We review the information about chronic myeloid leukemia (CML) and COVID-19: risk factors, prognosis, and the role of tyrosine kinase inhibitors (TKIs).At present, we find no data suggesting that patients with CML-chronic phase (CML-CP) are at higher risk of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than the general healthy population. TKIs had been proposed to fight the SARS-CoV-2-related disease (COVID-19). CML patients should continue receiving their TKIs if they have COVID-19 disease. The role of TKIs as protective factors against SARS-CoV-2 infection in patients with CML should be confirmed by large-scale epidemiologic studies.

PURPOSE The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America. METHODS Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020. RESULTS We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of cases. The main reason for such modifications was logistic issues (55.0%) and the most frequent modification was chemotherapy delay (42.0%). A total of 13.1% patients developed COVID-19 disease, with a mortality of 37.7%. Several factors were identified as independently associated with mortality, including a diagnosis of acute myeloid leukemia (odds ratio 2.38 [95% CI, 1.47 to 3.84]; P < .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82]; P = .014). CONCLUSION These results highlight the collateral damage of COVID-19 in oncology patients.

Made available in DSpace on 2022-04-29T08:45:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 This observational, multicenter study aimed to report the clinical evolution of COVID-19 in patients with chronic myeloid leukemia in Latin America. A total of 92 patients presented with COVID-19 between March and December 2020, 26% of whom were severe or critical. The median age at COVID-19 diagnosis was 48 years (22–79 years), 32% were 60 years or older, and 61% were male. Thirty-nine patients presented with at least one comorbidity (42.3%). Eighty-one patients recovered (88%), and 11 (11.9%) died from COVID-19. There was one case of reinfection. Patients with a major molecular response presented superior overall survival compared to patients with no major molecular response (91 vs. 61%, respectively; p = 0.004). Patients in treatment-free remission and receiving tyrosine kinase inhibitors showed higher survival rates than patients who underwent hematopoietic stem cell transplantation and those who did not receive tyrosine kinase inhibitors (100, 89, 50, and 33%, respectively; p < 0.001). Hematology and Hemotherapy Center University of Campinas Hospital Nacional Edgardo Rebagliati Martins Centro Médico Nacional Siglo XXI IMSS JM Ramos Mejia CABA Hospital de Transplantes Euryclides de Jesus Zerbini Faculdade de Medicina da Universidade Federal do Ceará Hospital Universitário Walter Cantídio Complexo Hospital de Clínicas–Universidade Federal do Paraná Laboratory of Medical Investigation in Pathogenesis and targeted therapy in Onco-Immuno-Hematology (LIM/31) Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Hospital de Valdivia Bueras Centro de Pesquisas Oncológicas Hospital dos Fornecedores de Cana de Piracicaba Hospital AC Camargo Cancer Center Hospital Universitário Antonio Pedro Universidade Federal Fluminense Hospitalization & Clinical Research Center Fundaleu Hospital Jorge Valente Hospital Santa Casa de Misericordia de Maceió Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto University of São Paulo Hospital Santa Marcelina São Paulo State University UNESP Medical School Campus de Botucatu Hemorio São Paulo State University UNESP Medical School Campus de Botucatu

Introduction The COVID-19 pandemic has affected the entire world. Health systems have been affected in such a way that patients with diseases other than COVID-19 have suffered serious consequences. In Latin America, the disease has emerged in a fragile system with more disparities, making our patients more vulnerable. Acute leukemia patients have a high risk of severe COVID-19 disease. Various expert recommendations have emerged with the aim of minimizing the risk of COVID-19 without affecting leukemia-related outcomes. However, multiple logistical issues tangentially associated with the pandemic have also appeared, potentially limiting the quality of management of these patients. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and its short-term consequences in Latin American countries. Methods We included patients older than 14 years, from 14 centers of 4 Latin American countries (Mexico, Peru, Guatemala and Panama), with the diagnosis of acute leukemia, who were on active treatment since the first case of COVID-19 was documented in each country. We documented their baseline characteristics and followed the patients prospectively until July 15, were data-cutoff for this pre-planned analysis was performed. The primary outcome was the incidence of COVID-19 disease and its complications. Secondary outcomes included treatment and consult modifications, and cause of death during the study period. Logistic regression was performed to determine factors associated with COVID-19 and all-cause mortality. Results We recorded the information of 635 patients: 58.1% Ph-negative ALL, 25.7% AML, 9% APL and 7.2% Ph+ALL. The median age was 35 years (14-90 years); 58.8% were consideredf high-risk patients. The majority were on CR (68.3%) receiving consolidation or maintenance therapy, while 14.5% were newly diagnosed and 17.2% with relapsed/refractory disease. The majority (91.8%) were treated in centers that were also receiving COVID-19 patients, 40.2% in centers were patients could not be electively hospitalized for leukemia treatment because of the COVID-19 pandemic. The COVID-pandemic led to treatment-modifications in 40.8% of the cases. Reasons for modifications were associated with logistical issues (22.4%), medical decisions (15.1%) or patient choice (3.3%). The most frequent modification was chemotherapy delay (17.3%) followed by regimen modification (13.4%) and dose-reductions (10.1%). (Figure 1) 83 patients (13.1%) developed COVID-19 disease, the majority mild-moderate disease (54.2%), 27.7% severe disease and 18.1% critically ill; 27.7% required mechanical ventilation and 37.7% died from COVID-19 disease, representing 4.9% of the entire cohort. We identify as risk factors for COVID-19 disease the presence of active leukemia (newly diagnosed or relapsed) (OR 3.46 [95% CI: 2.16-5.5], p On the other hand, 16.7% of patients died during period analyzed due to leukemia (57.5%), COVID-19 (29.2%) or treatment related-mortality (13.2%). Independent factors associated with mortality were AML vs. ALL (OR 1.89 [95% CI: 1.12-3.18], p=0.016), relapsed-refractory disease (OR 8.34 [95% CI: 4.83-14.41], p Discussion/Conclusions The COVID-19 pandemic led to significant modifications in the standard of care treatment of patients with acute leukemia. The incidence of COVID-19 disease in acute leukemia patients was considerable and more than a third of the patients with acute leukemia and COVID-19 disease died. Despite a short-follow up, 16.7% of the patients died and leukemia-related deaths were the most frequent. In low- and middle-income countries with fragile health systems, the collateral damage for patients with acute leukemia may be just as important as the direct consequences of COVID-19. Disclosures Alvarado: Roche: Speakers Bureau; Novartis: Speakers Bureau; Amgen: Speakers Bureau; Celgene: Speakers Bureau; Alexion: Speakers Bureau. De la Peña-Celaya:Amgen: Speakers Bureau; Janssen: Speakers Bureau; Novartis: Speakers Bureau. Perez:Roche: Speakers Bureau; Celgene: Speakers Bureau; Novartis: Speakers Bureau. Gomez-Almaguer:Amgen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; AbbVie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celgene/BMS: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; AstraZeneca: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Pfizer: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Roche: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.

Tyrosine kinase inhibitors (TKIs) have dramatically changed the survival of chronic myeloid leukemia (CML) patients, and treatment-free remission (TFR) has recently emerged as a new goal of CML treatment. The aim of this work was to develop recommendations for TKI discontinuation in Latin America (LA), outside of clinical trials. A working group of CML experts from LA discussed 22 questions regarding TFR and reached a consensus for TFR recommendations in the region. TFR is indicated in patients in first chronic phase, with typical BCR-ABL transcripts, under TKI treatment of a minimum of 5 years, in sustained deep molecular response (DMR; molecular response 4.5 [MR4.5]) for 2 years. Sustained DMR must be demonstrated on at least 4 international reporting scale quantitative polymerase chain reaction (PCR) tests, separated by at least 3 months, in the immediate prior 2 years. After second-line therapy, TFR is indicated in previously intolerant, not resistant, patients. Molecular monitoring is recommended monthly for the first 6 months, every 2 to 3 months from months 7 to 12, and every 3 months during the second year, indefinitely. Treatment should be reintroduced if major molecular response is lost. Monitoring of withdrawal syndrome, glucose levels, and lipid profile is recommended after discontinuation. After TKI reintroduction, molecular monitoring is indicated every 2 to 3 months until MR4.0 achievement; later, every 3 to 6 months. For the TFR attempt, having standardized and reliable BCR-ABL PCR tests is mandatory. These recommendations will be useful for safe discontinuation in daily practice and will benefit patients who wish to stop treatment in emergent regions, in particular, with TKI-related chronic adverse events.

Background: In Mexico, patients with hematologic malignancies (HMs) are characterized by being at high risk and advanced stages at diagnosis and by having a low cure rate; yet information on their experiences with health care and health-related quality of life (HRQL) is scarce. We aimed to evaluate experiences with health care and HRQL of patients with HMs and the association between these patient-reported measures. Methods: We conducted a cross-sectional survey in two public oncology hospitals in Mexico City. The study included outpatient cancer patients aged ≥18 years with a diagnosis of leukemia, lymphoma, or multiple myeloma. We used a patient-centered quality of cancer care questionnaire to assess patient experiences with receiving 1) timely care; 2) clear information; 3) information for treatment decision-making; 4) care to address biopsychosocial needs; and 5) respectful and coordinated care. We applied the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) to measure HRQL. We performed a multiple linear regression to evaluate the association between patient-reported experiences (independent variables) and the QLQ-C30 summary score (dependent variable). Results: Of the 515 participating HM patients, 46.6% had lymphoma, 34% leukemia, and 19.4% multiple myeloma; 70.9% were at advanced stages or at high risk. Additionally, 15.1% had anxiety and 12.8% had depression. Over one third (35.9%) reported receiving clear information, 28.5% timely care, 20.6% information for treatment decision-making, 23.7% care that addressed their biopsychosocial needs, and 31% respectful and coordinated care. The mean QLQ-C30 summary score was 71.9 points. Timely care, clear information, and care that addresses biopsychosocial needs were associated with higher HRQL. Conclusions: Health care services for HM patients at public oncology hospitals in Mexico need improvement. Notably, providing timely care, clear information, and care that addresses patients’ biopsychosocial needs can increase the likelihood of better HRQL. Health care providers should measure and improve the experiences of HM patients with health care.

El trabajo que se presenta a continuación está enfocado en mejoras para el laboratorio de Informática. La investigación se sustenta en la problemática encontrada en sus instalaciones, debido a las falencias existentes en el aula, y el no contar con recursos necesarios para la enseñanza, se convierte en un lugar inadecuado para recibir clases. El enfoque principal está en los puestos ocupacionales de los usuarios y el ambiente, los cuales no favorecen para mantener la postura correcta frente al computador, generando a futuro problemas lumbares, Escoliosis y otros. Como soporte del inconveniente encontrado se realizó el levantamiento de información con fuentes de investigación primaria, y por medio de encuestas se verificó la inconformidad de los estudiantes. El análisis de los datos permitió trabajar de manera generalizada en la propuesta y establecer recomendaciones, conclusiones para adecuación total del laboratorio, contribuyendo de esta forma con estrategias para mejorar sus instalaciones y precautelar la salud de los usuarios

Objetivo: Determinar la asociación entre calidad de vida relacionada con salud (CVRS) e incontinencia urinaria (IU) en una población de mujeres con exceso de peso del área urbana de Bucaramanga, Colombia. Materiales y métodos: Estudio analítico de corte transversal realizado entre marzo y mayo de 2012. La muestra estuvo conformada por 63 mujeres seleccionadas aleatoriamente,mediana de edad 46 años, con un mínimo de 18 y un máximo de 65 años, 76 % con sobrepeso y 24 % con obesidad. Se evalúo la CVRS con el SF-36 y el cuestionario de calidad de vida para mujeres con síntomas del tracto urinario bajo (ICIQ-FLUTSqol), la incontinencia urinaria se evaluó mediante la forma corta del cuestionario modular creado por el grupo Consulta Internacional sobre Incontinencia (ICIQ-IU Short Form). Resultados: La prevalencia de IU global fue de 39,7 %, IU esfuerzo 28,6 % e IU mixta 11,1 %. No se encontraron diferencias estadísticamente significativas en las 8 dimensiones del SF-36 entre mujeres con y sin IU. La dimensión con menor puntaje en las mujeres con IU fue vitalidad (63,4). El puntaje de CVRS evaluado con el cuestionario ICIQ-FLUTSqol obtuvo una mediana de 27 con un mínimo de 20 y máximo 52. Conclusión: En mujeres con exceso de peso no se observaron diferencias estadísticamente significativas en las 8 dimensiones de la CVRS al comparar las mujeres con y sin IU. Objective: To determine the association between quality of life health-related (HRQL) and urinary incontinence (UI) in a population of overweight women in the urban area of Bucaramanga, Colombia. Materials and methods: An analytic cross-sectional study was conducted in March and May 2012. The sample consisted of 63 randomly selected women; median age was 46 years with a minimum of 18 and maximum of 65 years, 76 % were overweight, and 24 % obese. We assessed the HRQL with the SF-36 questionnaire and lower urinary tract symptoms quality of life questionnaire (ICIQ-FLUTSqol). Urinary incontinence was assessed using the International Consultation on Incontinence questionnaire, short form (ICIQ-IU Short Form). Results: The overall prevalence of UI was 39.7 %; 28.6 % was Stress UI, mixed UI 11.1 %. There were no statistically significant differences in the eight dimensions of SF-36 in women with and without UI. The dimension with lowest score in women with IU was Energy-Fatigue (63.4). The HRQL scores assessed with ICIQ-FLUTSqol questionnaire was 27 with a minimum of 20 and a maximum of 55. Conclusion: In women with overweight, we do not found statistically significant differences in the eight dimensions of HR-QOL when comparing women with and without UI. Objetivo: Determinar a associacao entre Qualidade de Vida relacionada com Saude (CVRS) e incontinencia Urinaria (IU) em uma populacao de mulheres com excesso de peso da area urbana de Bucaramanga, Colombia. Materiais e métodos: Estudo analitico de corte transversal realizado entre Marco e Maio do 2012. A amostra esteve conformada por 63 mulheres selecionadas aleatoriamente, idade media de 46 anos com um minimo de 18 e um maximo de 65 anos, 76% com sobrepeso e 24% com obesidade. Avaliou-se a CVRS com o SF-36 e o questionario de qualidade de vida para mulheres com sintomas do trato urinario baixo (ICIQ-FLUTSqol), a incontinencia urinaria avaliou-se mediante a forma curta de questionario modular criado pelo grupo Consulta Internacional sobre Incontinencia (ICIQ-IU Short Form). Resultados: a prevalencia de IU global foi de 39,7%, IU Esforco 28,6% e IU mixta 11,1%. Nao se encontraram diferencas estatisticamente significativas nas 8 dimensoes do SF-36 entre mulheres com e sem IU. A dimensao com menor pontuacao nas mulheres com IU foi vitalidade (63,4). A pontuacao de CVRS avaliado com o questionario ICIQ-FLUTSqol obteve uma media de 27 com um minimo de 20 e máximo 52. Conclusão: em mulheres com excesso de peso nao se observaram diferencas estatisticamente significativas nas 8 dimensoes da CVRS ao comparar as mulheres com e sem IU.

West Nile fever is a mosquito-borne febrile illness seen in Africa, Asia, and Europe, but reported in North America only once. West Nile virus is of the family Flaviviridae, genus Flavivirus. Several West Nile fever outbreaks were reported from Israel in the 1950s and in 1980. Since the mid-1990s, frequency and apparent clinical severity of West Nile virus outbreaks have increased. Outbreaks in Rumania (1996), Russia (1999), and Israel (2000) involved hundreds of persons with severe neurologic disease. In the summer of 1999, West Nile virus was recognized in the among Western Hemisphere for the first time when it caused an epidemic of encephalitis and aseptic meningitis among residents of greater New York City. Other outbreak occurred during the summer of 2000. West Nile fever in humans usually is a febrile, influenza-like illness characterized by abrupt onset. Occasionally (less than 15% of cases) are acute aseptic meningitis or encephalitis. Although human vaccines for West Nile virus are under development, the most effective to way reduce local population of mosquitoes is to eliminate sources of standing water and preventing vector mosquitoes from biting humans by using mosquito repellents and barrier methods.

We report here a case of pulmonary aspergilloma in a patient with acute myeloblastic leukemia. We present the clinical and radiological characteristics of this case. Aspergillus flavus was isolated. The antifungal treatment was unsuccessful. Pulmonary aspergillomas are associated with a high mortality in the immunocompromised host. It is important to know the diagnostic approach and the surgical and medical treatment of this disease.

Abstract 4452 Background: Molecular Monitoring of BCR-ABL through standardized qPCR according to the international scale (IS) has been recently included in the follow-up of CML patients treated with tyrosine kinase inhibitors (TKIs) at the IMSS. The Molecular Biology Laboratory of the “Hospital of Specialties” at the “National Medical Center Siglo XXI”, have recently achieved full standardization of the qPCR technique to the international scale (using a conversion factor provided by Adelaide lab). The use of the IS in the molecular monitoring expressed as Bcr-Abl/Abl ratio in percentage is very important, since this is the best way to adopt appropriate strategies with TKI therapy. Objective: To report the evaluation of molecular status of 485 patients with CML attended at the Instituto Mexicano del Seguro Social using the IS in a reference standardized Mexican laboratory. Material and Methods: From August 2011 to May 2012, peripheral blood samples of 485 patients with CML, were sent to our laboratory. We extracted RNA as previously described. A minimum of 5 ml of whole blood was required in order to maximize optimal results. Then we put these results in our database and classified patient samples in five groups according the percentage of Bcr-Abl/Abl in the international scale: The first group were patients with >10% of Bcr-Abl; the second group were patients with >1–10% of Bcr-Abl; the third group were patients with >0.1–1%; the fourth group were patients with ≤0.1% and the fifth group were patients with undetectable Bcr-Abl transcripts. Results: We found the following distribution: Group I (> 10% Bcr-Abl): 91 patients (18.76%); Group II (>1–10% Bcr-Abl): 65 patients (13.4%); Group III (>0.1–1% Bcr-Abl) 83 patients (17.11%); Group IV (≤0.1% Bcr-Abl) 122 patients (25.15%); and Group V: undetectable Bcr-Abl: 124 patients (25.56%). Conclusion: Fifty percent of CML patients treated with nilotinib, imatinib or dasatinib, have reached a deep molecular response, that is, Major Molecular response (MMR) or better. Another 17% has reached a molecular response (>0.1–1%) that is equivalent to Complete Cytogenetic response (CCyR). This information is very useful for clinicians and should be interpreted individually according the lenght of treatment with TKIs, following current CML guidelines and recommendations. Until now, molecular monitoring using the IS was only possible through sending samples to US laboratories. It is important that Mexican clinicians at our institution have now the opportunity to rely on a Mexican validated and standardized laboratory. The results of the molecular response in this cohort of CML patients can be compared to the data of another countries using the IS. Classifying patients according to their molecular status could help to optimized therapies at our institution. Disclosures: Nacho-Vargas: Novartis Oncology: Employment.

Background: Nilotinib, a potent and highly selective BCR-ABL inhibitor, has been approved in more than 50 countries including Mexico. Nilotinib is indicated for the treatment of Philadelphia chromosome-positive chronic myelogenous leukemia (Ph+ CML) patients (pts) in chronic (CML-CP) or accelerated phase (CML-AP) resistant or intolerant to prior therapy including imatinib (IM). Before the approval of nilotinib by FDA or EMEA a Compassionate Use Program (CUP) of nilotinib was initiated in Mexico. Methods: The pts included in this program were adults pts with Ph+ CML, IM-resistant or –intolerant in all phases of the disease. IM resistance and intolerance were defined according to current guidelines (NCCN and ELN). Physical examination, EKG, bone marrow aspiration, karyotyping and BCR-ABL mutation screening were performed in all pts before starting nilotinib. All pts signed an informed consent. Nilotinib was administered orally at a dose of 400 mg twice daily (BID). No dose escalation was allowed. All pts were monitored with karyotyping. Patients that achieved CCyR were evaluated with quantitative RT-PCR for molecular evaluation. The results of CUP of nilotinib in Mexico are reported in this abstract including the cytogenetic, qRT-PCR and mutational analysis in a highly-resistant CML patient population. Results: Between October 2006 and June 2007, 47 pts were included in the nilotinib CUP in Mexico. The median age was 41.7 years (range 22–68) and 20 (44%) were men. Of the 47 pts, 28 (59.6%) had advanced phase CML which includes 7 (14.9%) blastic phase (BP) and 21 (44.7%) accelerated phase (AP) pts. 19/47 pts (40%) were in chronic phase (CP) of CML. Most patients were resistant to IM (86%) and 14% were IM-intolerant/resistant. The median duration since CML diagnosis was 73.8 months (range 14–183). The median duration of prior IM use was 27.6 months. All pts had been treated with hydroxiurea, interferon, and/or cytarabine prior to IM. At the time of starting nilotinib 17/47 pts (36.12%) had BCR-ABL mutations (P-loop mutations in 3 pts, IM binding mutations in 5 pts, catalytic domain mutations in 5 pts, and A-loop mutations in 4 pts). Only 3/47 pts (6.38%) had T315I mutation. The median duration of exposure to nilotinib was 304 days (range 19–632). Most pts tolerated nilotinib well and only one severe adverse event (AE) was reported (long-term myelosupression). At the time of data cut-off (July 31, 2008), 25 pts (53.2%) remain on therapy. Reasons for discontinuation of therapy were: lack of efficacy in 7/47 pts (14.9%) including 3 pts with T315I mutation; disease progression in 13/47 (27.5%); adverse events in 1/47 (2.1%); lost of follow-up in 1/47 (2.1%). The cytogenetic and molecular evaluation was performed after 12 and 18 months of treatment with nilotinib, respectively. The rate of overall hematological response (HR) was 79%. The major cytogenetic response (MCyR) according the phase of the disease were as follows: 57% in CP, 40% in AP and no MCyR was observed in BP. Of the 47 pts, 11 (23.4%) achieved CCyR, 5 (10.63%) achieved molecular responses including 2 (4%) with complete molecular response (CMR) and 3 (6%) with major molecular response (MMR). The current status of pts according baseline mutational analysis was: mutation detected/alive (8/47, 17%); no mutation detectable/alive (22/47, 46.8%); mutation detected/deceased (9/47, 19.2%); no mutation detectable/deceased (8/47, 17%). Conclusions: Nilotinib showed efficacy in IM-resistant or -intolerant CML pts in Mexico regardless of the presence or absence of BCR-ABL mutations. Nilotinib induced complete cytogenetic and molecular responses in some of the advanced and resistant CML patient population.