Chronic Myeloid Leukemia in India

Area of Science:

• Hematology
• Oncology
• Public Health

Background:

• Imatinib has revolutionized chronic myeloid leukemia (CML) management globally and in India.
• Accessible generic versions and patient programs have improved imatinib availability in India.
• Despite progress, unique challenges in CML management exist within the Indian healthcare landscape.

Purpose of the Study:

• To review and synthesize published data on chronic myeloid leukemia (CML) in India from 1990 to 2016.
• To analyze epidemiology, treatment monitoring, outcomes, and resistance patterns of CML in the Indian context.
• To identify gaps and areas for future research in Indian CML management.

Main Methods:

• Systematic review of published literature on CML in India (1990-2016).
• Utilized PubMed advanced search with specific keywords: "chronic myeloid leukemia" and "India".
• Included studies reporting on epidemiology, therapy monitoring, treatment outcomes, and resistance; reviewed article references.

Main Results:

• Identified 37 relevant studies; CML incidence in India may be lower than in Western countries, with limited population-based data.
• Indian patients often presented with more advanced CML disease.
• While imatinib is widely available as first-line therapy, molecular monitoring and second-line treatments are limited; impaired drug adherence (≥1/3 of patients) negatively impacted survival.

Conclusions:

• Prospective and cooperative studies are needed to enhance the quality of CML data from India.
• Future research should prioritize investigating drug adherence, its impact on outcomes, and effective intervention strategies.
• Addressing adherence is crucial for improving survival and treatment efficacy in Indian CML patients.