In a nutshell
This study looked at the best clinical practice guidelines in the diagnosis and treatment of chronic myeloid leukemia (CML). The study found that management of CML should be guided by patient age, medical conditions, and side effects of the chosen drug.
Some background
Chronic myeloid leukemia is a cancer of the bone marrow. It results from abnormal genes called a Philadelphia chromosome (Ph+). It is often treated with a drug which targets abnormal proteins on cancer cells (TKI – tyrosine kinase inhibitor) such as imatinib (Gleevec). These drugs can have many side effects. It is important to research the best treatment plans for patients with CML.
Methods & findings
New guidelines were published relating to best clinical practice in the diagnosis and management of CML.
Firstly, a full history should be taken from patients, followed by physical examination. All patients should be tested for the Ph+ abnormal genes. Selection of first-line TKI treatment should be based on patient age, health, and side effects of the drug. Recent data showed that dasatinib (Sprycel), nilotinib (Tasigna), and bosutinib (Bosulif) are more effective than imatinib as first-line therapies.
The effectiveness of TKI treatment should be measured by blood and bone marrow tests. Patients who do not respond to one TKI drug are recommended to switch to another TKI.
Most TKIs have well-tolerated side effects. For imatinib, side effects include tiredness and poor bone health. Dasatinib is linked with muscle problems, and low white blood cell counts. Side effects of nilotinib include nausea, diarrhea, and vomiting.
The bottom line
Researchers concluded that the diagnosis and treatment of CML should be managed by patient age, condition, and side effects of the medication.
Published By :
Journal of the National Comprehensive Cancer Network
Date :
Sep 01, 2018
