16-Year Epidemiologic Study of Chronic Myeloid Leukemia in Azerbaijan: Clinical and Molecular Insights

Abstract
Background:
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm with a global incidence of 0.5–2 per 100,000 population. However, comprehensive epidemiologic data from Azerbaijan remain limited.
Methods:
A retrospective nationwide cohort study was conducted at the National Hematology and Blood Transfusion Center, the sole hematology referral center in Azerbaijan. All patients diagnosed with CML between 2008 and 2023 were included. Demographic, clinical, molecular, and treatment data were extracted from medical records. Descriptive analyses assessed temporal trends, age and sex distribution, seasonal and geographic patterns, ABO/Rh blood groups, kinase domain mutations, treatment response, and survival.
Results:
Study included 766 patients , with a female predominance (54%) and the highest disease burden observed in individuals aged 50–59 years. CML incidence increased from 0.31 to 0.86 per 100,000 population between 2008 and 2023, while prevalence rose more than twelve-fold. Following the introduction of tyrosine kinase inhibitors (TKIs), five-year overall survival exceeded 80%. Most patients resided in the Absheron region, suggesting possible environmental or industrial influences. New diagnoses were more frequent during summer months (29.6%). Blood group A was more prevalent among patients compared with controls (40.3% vs 35.4%). First-line imatinib achieved optimal molecular responses in approximately 80% of patients, while 15% experienced treatment failure. Among 115 patients tested, T315I was the most common BCR-ABL mutation.
Conclusions:
This nationwide CML analysis from Azerbaijan reveals a rising disease burden, female predominance, and favorable survival outcomes with TKI therapy. The findings emphasize the need for sustained access to molecular diagnostics and support national strategies for equitable CML care.