Audiological profile for assessment of sensorineural hearing loss in treatment naïve chronic myeloid leukemia: impact of early TKI treatment on reversibility

Sensorineural hearing loss (SNHL) is an underrecognized manifestation in chronic myeloid leukemia (CML), particularly in the setting of hyperleukocytosis. Its prevalence, pathophysiology, and response to tyrosine kinase inhibitor (TKI) therapy remain poorly characterized. To assess the prevalence, severity, and reversibility of SNHL in treatment-naïve CML patients and evaluate associations with leukocyte count and disease risk. In this prospective study, 102 newly diagnosed CML patients with total leucocyte count (TLC) > 50 × 109/L underwent audiological evaluation at baseline, 3 months, and 6 months post-initiation of imatinib. Age- and sex-matched healthy controls were included for comparison. SNHL was identified in 45.1% of CML patients at diagnosis, predominantly affecting mid-to-high frequencies. Elevated TLC (> 150 × 109/L) and intermediate-high EUTOS long term survival (ELTS) scores were significantly associated with SNHL (p < 0.05). Following TKI therapy, 74% of patients with minimal-to-mild SNHL showed complete audiometric recovery at 6 months. No worsening was observed in patients with normal baseline hearing. SNHL is a prevalent but potentially reversible complication in newly diagnosed CML, with early TKI therapy facilitating hearing recovery. Routine audiological screening should be considered at diagnosis to detect subclinical hearing loss.