Skip to main content

Advertisement

Log in

Molecular monitoring of tyrosine kinase inhibitor therapy of chronic myeloid leukemia in China

  • Original Article – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Explore molecular monitoring patterns of patients with chronic myeloid leukemia (CML) on tyrosine kinase inhibitors therapy in China and identify variables associated with monitoring patterns.

Methods

Non-interventional, cross-sectional study using questionnaires distributed to persons with CML and answered anonymously.

Results

A total of 819 respondents in chronic phase outside clinical trials were evaluable; 477 respondents (58 %) were male. Median age was 41 years (range 18–88 years). A total of 609 (74 %) respondents received a TKI <1 year after diagnosis and 665 (81 %) were on a branded TKI. Median TKI therapy duration was 3 years (range <1–13 years). A total of 255 (31 %) respondents had a molecular test every 3 months, and 280 (34 %), every 6 months. Multivariate analyses showed that older age, starting TKI therapy >1 year after diagnosis and generic TKI use were associated with deviation from recommended monitoring frequency (both every 3 months and every 3 or 6 months). In addition, TKI therapy duration >3 years and imatinib use were associated with under-testing every 3 months. Rural household registration was associated with less testing at every 3 or 6 months. The most commonly stated reasons for under-testing were no requirement by physician (60 %), followed by cost (19 %), no necessity (10 %) and no eligible lab nearby (10 %).

Conclusions

Many Chinese with chronic phase CML receiving TKI therapy do not have response monitoring compliant with recommended guidelines. Older age, financial burden and physician non-adherence to guideline recommendations are associated with low monitoring frequencies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Baccarani M, Deininger MW, Rosti G et al (2013) European LeukemiaNet recommendations for the management of chronic myeloid leukemia. Blood 122:872–884

    Article  CAS  PubMed  Google Scholar 

  • Chen L, Guerin A, Xie J et al (2012) Monitoring and switching patterns of patients with chronic myeloid leukemia treated with imatinib in community settings: a chart review analysis. Curr Med Res Opin 28:1831–1839

    Article  CAS  PubMed  Google Scholar 

  • Cross NC, White HE, Müller MC, Saglio G, Hochhaus A (2012) Standardized definitions of molecular response in chronic myeloid leukemia. Leukemia 26(10):2172–2175

    Article  CAS  PubMed  Google Scholar 

  • Cross NC, Hochhaus A, Müller MC (2015a) Molecular monitoring of chronic myeloid leukemia: principles and interlaboratory standardization. Ann Hematol 94(Suppl 2):S219–S225

    Article  PubMed  Google Scholar 

  • Cross NC, White HE, Colomer D et al (2015b) Laboratory recommendations for scoring deep molecular responses following treatment for chronic myeloid leukemia. Leukemia 29(5):999–1003

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Egan D, Radich J (2015) Prognosis and molecular monitoring in chronic myeloid leukemia. Clin Lymphoma Myeloma Leuk 15(Suppl):S109–S113

    Article  PubMed  Google Scholar 

  • Goldberg SL (2015) Monitoring chronic myeloid leukemia in the real world: gaps and opportunities. Clin Lymphoma Myeloma Leuk 15(12):711–714

    Article  PubMed  Google Scholar 

  • Goldberg SL, Chen L, Guerin A et al (2013) Association between molecular monitoring and long-term outcomes in chronic myelogenous leukemia patients treated with first line imatinib. Cur Med Res Opin 29:1075–1082

    Article  CAS  Google Scholar 

  • Goldberg SL, Cortes JE, Gambacorti-Passerini C et al (2014) Cytogenetic and molecular testing in patients with chronic myeloid leukemia in a prospective observational study (SIMPLICITY). J Clin Oncol (ASCO Annual Meeting Abstracts) 32; abstract 7050

  • Goldberg SL, Akard LP, Dugan MJ, Faderl S, Pecora AL (2015) Barriers to physician adherence to evidence-based monitoring guidelines in chronic myelogenous leukemia. J Oncol Pract 11:e398–e404

    Article  PubMed  Google Scholar 

  • Guérin A, Chen L, Dea K, Wu EQ, Goldberg SL (2014a) Association between regular molecular monitoring and tyrosine kinase inhibitor therapy adherence in chronic myelogenous leukemia in the chronic phase. Curr Med Res Opin 30:1345–1352

    Article  PubMed  Google Scholar 

  • Guérin A, Chen L, Dea K, Wu EQ, Goldberg SL (2014b) Economic benefits of adequate molecular monitoring in patients with chronic myelogenous leukemia. J Med Econ 17:89–98

    Article  PubMed  Google Scholar 

  • National Comprehensive Cancer Network (2015) NCCN clinical practice guidelines in oncology: chronic myelogenous leukemia version 1 (2016) Fort Washington PA. National Comprehensive Care Network. 2015. http://www.nccn.org/professionals/physician_gls/pdf/cml.pdf. Accessed 26 Mar 2016

  • Radich JP (2014) Monitoring molecular response to tyrosine kinase therapy in chronic myelogenous leukemia. J Natl Compr Cancer Netw 12(5 Suppl):817–820

    Google Scholar 

  • Saleh MN, Haislip S, Sharpe J et al (2014) Assessment of treatment and monitoring patterns and subsequent outcomes among patients with chronic myeloid leukemia treated with imatinib in a community setting. Curr Med Res Opin 30:529–536

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by National Natural Science Foundation of China (No. 81370637). RPG acknowledges support from the National Institute of Health Research (NIHR) Biomedical Research Centre funding scheme.

Author contributions

JQ designed the study, collected, analyzed and interpreted the data, and drafted the article. RPG interpreted the data and drafted the article. All authors read and approved the final typescript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Qian Jiang.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Because the survey used anonymous questionnaires, the Ethics Committee of Peoples Hospital determined informed consent of participants was not required.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 25 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jiang, Q., Gale, R.P. Molecular monitoring of tyrosine kinase inhibitor therapy of chronic myeloid leukemia in China. J Cancer Res Clin Oncol 142, 1549–1555 (2016). https://doi.org/10.1007/s00432-016-2158-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00432-016-2158-8

Keywords

Navigation