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Comprehensive Protocol to Sample and Process Bone Marrow for Measuring Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia
Published on: March 5, 2018
Adapting UK Clinical Practise in Chronic Myeloid Leukaemia in Chronic Phase to Contemporary Management
Dragana Milojkovic1, Nicholas C P Cross2, Ketul Desai3
1Centre for Haematology, Faculty of Medicine, Imperial College London, and Department of Haematology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
Objective:
Chronic myeloid leukaemia in chronic phase (CML-CP) treatment recommendations have changed substantially in recent years. The ADAPT 2.0 survey aimed to provide an updated understanding of CML-CP management in the UK.
Methods:
This healthcare professional (HCP) survey, conducted between December 2023 and June 2024, assessed treatment goals, choice of tyrosine kinase inhibitors (TKIs), unmet needs and approaches to treatment-free remission (TFR).
Results:
UK CML-CP practise is generally aligned with the contemporary guidelines for CML management. Key treatment goals were major molecular response (54%-77% across treatment lines) and deep molecular response (5%-46%). The main factors influencing first-line (1 L) TKI selection were treatment guidelines (97%), comorbidities (90%) and TFR as a treatment goal (82%). Therapy switch after one warning European LeukemiaNet (ELN) 2020 response was rare (10% vs. 56% in patients with > 1 warning response and 100% in failure response). BCR::ABL1 mutation analysis was less common after one warning response versus > 1 warning response (54% vs. 82%). TKI toxicity, resistance, intolerance and T315I mutation management were key unmet needs in later treatment lines; achieving and maintaining TFR were key unmet needs in 1 L.
Conclusion:
The ADAPT 2.0 survey highlights potential areas of improvement in current CML-CP management in the UK.
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