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Chronic myeloid leukemia in Asia

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Abstract

Chronic myeloid leukemia (CML) in Asia has an incidence rather lower than in Western countries yet tends to afflict a younger population. As in the West, imatinib mesylate (IM, Glivec) has supplanted busulphan, hydroxyurea and interferon-α as first-line treatment. Its use has resulted in a dramatic decline in the number of hematopoietic stem cell transplantations (HSCT) performed. Although it is expensive, IM induces a complete cytogenetic response in 60–90% of newly diagnosed patients, and up to 10% for those in blastic phase. The standard dose of 400 mg is well tolerated by most patients, although adverse events have been observed, including drug-induced cytopenia. Through the Glivec International Patient Assistance Program, the majority of CML patients has access to IM and can expect prolonged survival, even in the absence of HSCT. However, just as in Western countries, resistance to imatinib has emerged in Asian countries. They will require the novel tyrosine kinase inhibitors (dasatinib, nilotinib) becoming available through either clinical trials or market approval. This review examines the available data on CML in China, Hong Kong, India, the Philippines, Singapore, South Korea, Taiwan and Thailand.

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Acknowledgments

The author from Singapore would like to acknowledge the contributions of Ms Yang Li Yi, Mr Sun Wen Tian and Mr Vallalan Natesan for the analysis of Bcr-Abl kinase mutation and Ms Clairice Lim, Ms Valerie Wee and Dr William Hwang for data management. The work was supported by funds from the Singapore Cancer Syndicate (SCS-TS0065 and SCS-AS0076). The authors from Korea would like to acknowledge Dr Hyun-Gyung Goh, Dr Sahee Park, the Korean Society of Hematopoietic Stem Cell Transplantation and Korean Nursing Group of HSCT. This work was supported by a grant from the National Cancer Control R&D Program 2003 (0320290-3), Ministry of Health and Welfare (Republic of Korea), and by a grant no. R21-2002-000-00010-0 (2007) from the National Research Resource Bank Program of the Korea Science and Engineering Foundation, Ministry of Science and Technology. The author from Hong Kong would like to thank Dr Raymond Liang (University Of Hong Kong), Mr Oscar Man (Hong Kong Cancer Registry), Ms Win Lui (QMH records office), Ms Crosby Lu (BMT registry) and Ms Peggy Chiu (HLA registry) for data management; and Dr Edmond SK Ma (Hong Kong Sanatorium Hospital) for data on Bcr/Abl mutations. The author from China is indebted to Dr Chunlin Zhou (Peking Union Medical College) for his involvement in the manuscript preparation. The author from India acknowledges the important contribution of Dr Lalit Kumar (IRCH, All India Institute of Medical Sciences, New Delhi).

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Authors and Affiliations

  1. Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong

    Wing Y. Au

  2. UST Hospital and St Luke’s Medical Center, University of Santo Tomas Faculty of Medicine and Surgery, Manila, The Philippines

    Priscilla B. Caguioa

  3. Department of Hematology, Singapore General Hospital and Duke-NUS Graduate Medical School, Singapore, Singapore

    Charles Chuah

  4. Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Szu Chun Hsu

  5. Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand

    Saengsuree Jootar

  6. Division of Hematology, CML Clinical Research Institute, 3rd floor, St Mary’s Hospital, The Catholic University of Korea, 62 Youidodong Youngdeungpogu, 150-713, Seoul, South Korea

    Dong-Wook Kim & Il-Young Kweon

  7. BioMedCom Consultants, Inc., Montreal, QC, Canada

    William M. O’Neil

  8. Prince Aly Khan Hospital and Jaslok Hospital, Mumbai, India

    Tapan K. Saikia

  9. Department of Clinical Hematology, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease, Hospital of the Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China

    Jianxiang Wang

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  1. Wing Y. Au
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  10. Jianxiang Wang
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Correspondence to Dong-Wook Kim.

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All authors contributed equally to the conception and preparation of the manuscript.

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Au, W.Y., Caguioa, P.B., Chuah, C. et al. Chronic myeloid leukemia in Asia. Int J Hematol 89, 14–23 (2009). https://doi.org/10.1007/s12185-008-0230-0

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