Advanced phase chronic myeloid leukaemia (CML) in the tyrosine kinase inhibitor era - a report from the Swedish CML register

Research output: Contribution to journalArticle

Abstract

Objectives: The primary goal in management of chronic phase (CP) chronic myeloid leukaemia (CML) is to prevent disease progression to accelerated phase (AP) or blast crisis (BC). We have evaluated progression rates in a decentralised healthcare setting and characterised patients progressing to AP/BC on TKI treatment. Methods: Using data from the Swedish CML register, we identified CP-CML patients diagnosed 2007-2011 who progressed to AP/BC within 2 yrs from diagnosis (n = 18) as well as patients diagnosed in advanced phase during 2007-2012 (n = 36) from a total of 544 newly diagnosed CML cases. We evaluated baseline characteristics, progression rates, outcome and adherence to guidelines for monitoring and treatment. Results: The cumulative progression rate at 2 yrs was 4.3%. All 18 progression cases had been treated with imatinib, and six progressed within 6 months. High-risk EUTOS score was associated to a higher risk of progression. Insufficient cytogenetic and/or molecular monitoring was found in 33%. Median survival after transformation during TKI treatment was 1.4 yrs. In those presenting with BC and AP, median survival was 1.6 yrs and not reached, respectively. Conclusion: In this population-based setting, progression rates appear comparable to that reported from clinical trials, with similar dismal patient outcome. Improved adherence to CML guidelines may minimise the risk of disease progression.

Details

Authors
  • Stina Söderlund
  • Torsten Dahlén
  • Fredrik Sandin
  • Ulla Olsson-Strömberg
  • Maria Creignou
  • Arta Dreimane
  • Anna Lübking
  • Berit Markevärn
  • Anders Själander
  • Hans Wadenvik
  • Leif Stenke
  • Johan Richter
  • Martin Höglund
Organisations
External organisations
  • Uppsala University Hospital
  • Karolinska Institutet
  • Linköping University Hospital
  • Skåne University Hospital
  • Norrland University Hospital
  • Umeå University
  • Sahlgrenska University Hospital
  • Regional Cancer Centre Uppsala/Örebro
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology

Keywords

  • Accelerated phase, Blast crisis, Chronic myeloid leukaemia, Population-based, Tyrosine kinase inhibitor
Original languageEnglish
Pages (from-to)57-66
JournalEuropean Journal of Haematology
Volume98
Issue number1
Early online date2016
Publication statusPublished - 2017 Jan
Publication categoryResearch
Peer-reviewedYes