Tyrosine kinase inhibitor usage, treatment outcome, and prognostic scores in CML: report from the population-based Swedish CML registry

Abstract

Key Points• Patients up to age 70 years with CML treated within a decentralized health care setting had a relative survival close to 1.0. • Sokal, but not EUTOS, score at diagnosis predicted overall and relative survival in a population-based cohort of patients with CML.Clinical management guidelines on malignant disorders are generally based on data from clinical trials with selected patient cohorts. In Sweden, more than 95% of all patients diagnosed with chronic myeloid leukemia (CML) are reported to the national CML registry, providing unique possibilities to compile population-based information. This report is based on registry data from 2002 to 2010, when a total of 779 patients (425 men, 354 women; median age, 60 years) were diagnosed with CML (93% chronic, 5% accelerated, and 2% blastic phase) corresponding to an annual incidence of 0.9/100 000. In 2002, approximately half of the patients received a tyrosine kinase inhibitor as initial therapy, a proportion that increased to 94% for younger (<70 years) and 79% for older (>80 years) patients during [2007][2008][2009]. With a median follow-up of 61 months, the relative survival at 5 years was close to 1.0 for patients younger than 60 years and 0.9 for those aged 60 to 80 years, but only 0.6 for those older than 80 years. At 12 months, 3% had progressed to accelerated or blastic phase. Sokal, but not European Treatment and Outcome Study, high-risk scores were significantly linked to inferior overall and relative survival. Patients living in university vs nonuniversity catchment areas more often received tyrosine kinase inhibitors up front but showed comparable survival. (Blood. 2013;122(7):1284-1292

Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries

“…There is clear evidence that survival (Hoglund et al 2013) of CML patients is close to the age-matched general population and also quality of life in the aged-matched general population is similar for most CML patient groups (Efficace et al 2011) when CML is treated effectively in chronic phase with current therapies. However, every fifth patient is classified as having "low adherence" according to the MMAS.…”

Digital PCR (Dpcr) a Step Forward to Detection and Quantification of Minimal Residual Disease (MRD) in Ph+/BCR-ABL1 Chronic Myeloid Leukemia (CML)

“…This translocation, leading to a new, hybrid, leukemia-specific gene (BCR-ABL1) encoding for a deregulated tyrosine-kinase protein (p210), drives the leukemic transformation of hematopoietic stem cells [1][2][3][4][5][6] and induces the progression of the disease from the early chronic phase (CP) to the late blastic phase BP) which close the natural history of the disease.…”

The value of open access and a patient centric approach to oral oncolytic utilization in the treatment of Chronic Myelogenous Leukemia: A U.S. perspective

“…There are several studies that provide estimates of the underlying distribution of disease progression risk scores in newly diagnosed CML patients. Clinical trials and real-world registry data have consistently shown that approximately two-thirds of patients are at intermediate or high risk of disease progression at diagnosis (Figure 1) [14][15][16]. Implementing generic imatinib step edits irrespective of disease progression risk level is inconsistent with the NCCN guidelines and has the potential to compromise clinical outcomes of a large proportion of CML patients.…”