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Looking Beyond Overall Survival in Chronic Myeloid Leukemia

Christin Melton, ELS
Published: Thursday, Aug 30, 2018
 Harry Erba, MD, PhD

Harry Erba, MD, PhD
Chronic myeloid leukemia (CML) is one of the great success stories in anticancer therapy. The introduction of tyrosine kinase inhibitors (TKIs) transformed CML from a life-threatening disease to a chronic one for most patients. Although CML remains incurable without a stem cell transplant, the life expectancy for a patient with newly diagnosed disease today approaches that of the general population.1 The result, said Harry P. Erba, MD, PhD, moderator of an OncLive Peer Exchange® panel on current strategies for managing CML, is that the prevalence of CML is rising. One study estimated the prevalence of CML at 70,000 in 2010 and predicted it would increase to 112,000 in 2020, with further increases every decade thereafter before peaking at 181,000 in 2050.2

panel, Erba and panelists Michael J. Mauro, MD, and Jorge E. Cortes, MD, discussed how new data on TFR and updated guidelines for monitoring patients have influenced their approach in the clinic.

Figure 1. Clinically Relevant Thresholds of BCR-ABL16

Clinically Relevant Thresholds of BCR-ABL1

Optimizing Outcomes With Proper Monitoring

Cortes started the discussion of monitoring by noting that although “close monitoring is critical to optimize benefits [of TKI therapy],”3 only 30% of patients with CML in the United States receive molecular monitoring at the appropriate intervals after starting a first-line TKI. He said failure to monitor patients appropriately prevents clinicians from identifying patients who respond poorly to the initial TKI while time remains to affect outcomes.
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