Chronic myeloid leukemia in Asia
Journal
International Journal of Hematology
Journal Volume
89
Journal Issue
1
Pages
14-23
Date Issued
2009
Author(s)
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. ? 2008 The Japanese Society of Hematology.
Subjects
Asia; Chronic myeloid leukemia (CML); Epidemiology; Treatment
SDGs
Other Subjects
alpha interferon; alpha1 interferon; alpha1b interferon; alpha2a interferon; alpha2b interferon; bosutinib; busulfan; cytarabine; dasatinib; homoharringtonine; hydroxyurea; imatinib; nilotinib; recombinant granulocyte colony stimulating factor; unclassified drug; Asia; China; chromosome analysis; chronic myeloid leukemia; clinical practice; clinical trial; cytopenia; drug blood level; drug efficacy; drug megadose; drug withdrawal; epidemiological data; event free survival; graft versus host reaction; health care cost; health insurance; hematopoietic stem cell transplantation; Hong Kong; human; incidence; India; long term care; low drug dose; neutropenia; opportunistic infection; optimal drug dose; pancytopenia; Philippines; practice guideline; prognosis; real time polymerase chain reaction; reimbursement; review; risk benefit analysis; risk management; Singapore; South Korea; Taiwan; Thailand; thrombocytopenia; treatment response; unspecified side effect; Asia; Drug Resistance, Neoplasm; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Treatment Outcome
Type
review