Therapy decisions in leukemia

Complex factors determine how physicians select between alternative therapies. We conducted a survey of 352 leukemia experts to determine consensus regarding optimal treatment for leukemia and to identify factors correlated with therapy decisions. The study evaluated both general treatment policies and recommendations for specific clinical situations. Responses of chemotherapy, allotransplant and autotransplant experts were compared. Although responses of these groups were similar for general treatment policies, recommendations for specific cases differed substantially. Interestingly, responses of the three groups to some clinical situations also differed from conclusions of several published studies examining these issues. These data suggest that experts may discount published results in favor of personal experiences, perceptions of the best treatment strategy (based on published data or not) or available resources.