Blood Res 2021; 56(1):
Published online March 31, 2021
https://doi.org/10.5045/br.2021.2020260
© The Korean Society of Hematology
Correspondence to : Chul Won Jung, M.D., Ph.D.
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
E-mail: leukemia1@skku.edu
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background
The global TARGET survey examined real-world management of chronic myeloid leukemia (CML) compared with international guideline recommendations. This report focused on the responses of physicians from South Korea compared with those of physicians from the rest of the world (ROW).
Methods
The self-administered, online survey, comprising 23 questions and clinical case scenarios, was completed between April and August 2017. It was designed to gather information on practicing physicians and local practices for CML diagnosis, disease monitoring, treatment, and adverse event (AE) management.
Results
While there were similarities in the mutation analysis and treatment efficacy between Korea and the ROW, there were also differences in CML management. Initial diagnostic testing was more comprehensive in Korea than in the ROW, and there was significantly better access to standardized polymerase chain reaction testing. Assessment of BCR-ABL levels during the first 12 months of treatment was excellent in Korea, and there was greater frontline use of second-generation BCR-ABL tyrosine kinase inhibitors. Korean physicians were significantly less likely to switch therapy for hematologic AEs. Treatment-free remission was not an important goal of therapy among Korean or ROW physicians.
Conclusion
This study identified some differences in the current CML management between Korea and the ROW; CML management in Korean patients was generally in line with the current guidelines.
Keywords Chronic myeloid leukemia, Management, Tyrosine kinase inhibitors, Real-life practice, Treatment-free remission
Blood Res 2021; 56(1): 31-37
Published online March 31, 2021 https://doi.org/10.5045/br.2021.2020260
Copyright © The Korean Society of Hematology.
Jieun Uhm1, Kyoung Ha Kim2, Hyewon Lee3, Hawk Kim4, Slader Cassandra5, Inkyung Joo6, Chul Won Jung7
Division of Hematology Oncology, Department of Internal Medicine, 1Hanyang University Hospital, Hanyang University College of Medicine, 2Soonchunhyang University College of Medicine, Seoul, 3Division of Tumor Immunology and Center for Hematologic Malignancies, Research Institute and Hospital, National Cancer Center, Goyang, 4Division of Hematology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, 5Novartis, Ltd., 6Novartis Korea, 7Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence to:Chul Won Jung, M.D., Ph.D.
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
E-mail: leukemia1@skku.edu
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background
The global TARGET survey examined real-world management of chronic myeloid leukemia (CML) compared with international guideline recommendations. This report focused on the responses of physicians from South Korea compared with those of physicians from the rest of the world (ROW).
Methods
The self-administered, online survey, comprising 23 questions and clinical case scenarios, was completed between April and August 2017. It was designed to gather information on practicing physicians and local practices for CML diagnosis, disease monitoring, treatment, and adverse event (AE) management.
Results
While there were similarities in the mutation analysis and treatment efficacy between Korea and the ROW, there were also differences in CML management. Initial diagnostic testing was more comprehensive in Korea than in the ROW, and there was significantly better access to standardized polymerase chain reaction testing. Assessment of BCR-ABL levels during the first 12 months of treatment was excellent in Korea, and there was greater frontline use of second-generation BCR-ABL tyrosine kinase inhibitors. Korean physicians were significantly less likely to switch therapy for hematologic AEs. Treatment-free remission was not an important goal of therapy among Korean or ROW physicians.
Conclusion
This study identified some differences in the current CML management between Korea and the ROW; CML management in Korean patients was generally in line with the current guidelines.
Keywords: Chronic myeloid leukemia, Management, Tyrosine kinase inhibitors, Real-life practice, Treatment-free remission
Table 1 . Physicians’ responses regarding how hypothetical patients receiving first-line treatment for chronic-phase CML would be managed based on
% of respondents | Physicians’ response (N=41) | ||
---|---|---|---|
Immediately switch | Re-evaluate in 30–60 days | Will not switch | |
ELN-defined optimal response [7] | |||
Korea | 7 | 27 | 66 |
ROW | 18 | 28 | 53 |
ELN-defined suboptimal response [7] | |||
Korea | 5 | 66 | 29 |
ROW | 15 | 55 | 29 |
Korea | 2 | 61 | 37 |
ROW | 13 | 51 | 35 |
Korea | 2 | 63 | 34 |
ROW | 14 | 52 | 33 |
ELN-defined treatment failure [7] | |||
Korea | 76 | 15 | 10 |
ROW | 76 | 20 | 4 |
Korea | 73 | 17 | 10 |
ROW | 74 | 20 | 6 |
Abbreviations: CML, chronic myeloid leukemia; ELN, European LeukemiaNet; ROW, rest of the world..
Jieun Uhm
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