OBJECTIVES: To examine patient and disease characteristics and treatment patterns among patients with chronic myeloid leukemia (CML) in multiple countries.
METHODS: Oncologists and hematologists in the United States (US), UK (UK), Germany, and Japan abstracted medical charts of adult patients with CML between January 1, 2005 and December 31, 2009. Patients were in chronic phase at diagnosis, either Ph or BCR-ABL positive, had received first line treatment with imatinib, and had not participated in a randomized clinical trial for CML. A subset of patients received 2nd-line therapy with nilotinib or dasatinib.
RESULTS: A total of 214 physicians provided data on 1,063 patients (range 220 – 300 per country). Patients were 55 years of age on average and 60% were male. Nearly 67% of patients did not have any comorbidity, although when present, diabetes was most common in all countries (5% in Japan to 18% in Germany). Patients initiated imatinib within 3 months after diagnosis, and received therapy for 22 months on average (19 months [US] to 25 months [Japan]), at a median daily dose of 400mg in all countries. Approximately 13% of patients (8% in Japan to 16% in UK) had a dose escalation to a median dose of 800mg. 29% of patients discontinued imatinib, primarily due to resistance to therapy or disease progression. 2nd-line treatment patterns were studied among 261 patients (148 dasatinib, 113 nilotinib). Patients in the US and Germany had more nilotinib use (54%) while only 17% of UK patients used nilotinib. Patients initiated 2nd-line therapy 25 months after initial diagnosis, and received treatment for 11 months (dasatinib) or 7 months (nilotinib). More patients initiating dasatinib had advanced disease (25% accelerated, 4% blast phase) compared to nilotinib (25% accelerated, 1% blast phase).
CONCLUSIONS: Patient characteristics and treatment patterns in CML vary by country.
