Treating Chronic Myeloid Leukemia

Abstract

The tremendous progress made in chronic myeloid leukemia (CML) treatment affords patients more options than ever. Five currently available BCR-ABL inhibitors form the mainstay of CML treatment, including first-generation imatinib and more potent second-generation BCR-ABL inhibitors dasatinib and nilotinib, with bosutinib and ponatinib having been recently approved for market inclusion. Studies show that dasatinib and nilotinib exhibit greater efficacy than imatinib in first-line chronic-phase CML (CML-CP), allowing more patients to achieve deeper, more rapid responses associated with improved outcomes. With alternatives to imatinib for first-line CML-CP and the wealth of information (and misinformation) on the Internet, a tremendous need exists for clear, accurate facts to assist patients in making treatment decisions. Patients appreciate the guidance of their oncology nurse in providing disease, treatment, and monitoring information tailored to meet their needs. Oncology nurses who are able to clearly explain emerging data, including the meaning and significance of faster, deeper responses, will be a valuable resource to their patients.

Drivers and Barriers to Medication Adherence in Patients with Chronic Myeloid Leukaemia: A Qualitative Study

“…The 20 participants were aged between 36-75 years (mean 60.9) and had been diagnosed for [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] years (mean 6.23). 18 had a partner, all had children (four living at home) and 13 were grandparents.…”

“…If untreated, CP-CML will progress to an accelerated phase (AP-CML) and a fatal blast phase (BP-CML) in three to five years [1,4,5].…”

“…It affects slightly more men than women and has an average onset at 64-68 years. Most patients (60-85%) are diagnosed in the initial chronic phase (CP-CML) based on symptoms such as night sweats, abdominal pain, infections, fatigue, weight loss, or bruising [1][2][3].…”

“…As CML is a lowgrade symptom disease, treatment often represents patients' main disease impact [3,10]. Side effects are mostly considered mild to moderate but may include edema, diarrhoea, pleural effusions, nausea, muscosceletal or abdominal pain, rashes, fatigue, or headache [1][2][3][4]7,9,[11][12][13][14][15][16][17][18][19][20][21].…”

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

“…Most patients are diagnosed in the chronic phase and both untreated and treated patients can progress to an accelerated phase (AP) and the fatal blast crisis (BC) phase [3,4]. The introduction of tyrosine kinase inhibitors (TKIs) has improved the CML treatment landscape beyond traditional cytotoxic chemotherapeutic agents or interferon-alpha.…”