Chronic myeloid leukemia in Asia.
Chronic myeloid leukemia (CML) in Asia has an incidence rather lower than in Western countries yet tends to afflict a younger population. As in the West, imatinib mesylate (IM, Glivec) has supplanted busulphan, hydroxyurea and interferon-alpha as first-line treatment. Its use has resulted in a dramatic decline in the number of hematopoietic stem cell transplantations (HSCT) performed. Although it is expensive, IM induces a complete cytogenetic response in 60-90% of newly diagnosed patients, and up to 10% for those in blastic phase. The standard dose of 400 mg is well tolerated by most patients, although adverse events have been observed, including drug-induced cytopenia. Through the Glivec International Patient Assistance Program, the majority of CML patients has access to IM and can expect prolonged survival, even in the absence of HSCT. However, just as in Western countries, resistance to imatinib has emerged in Asian countries. They will require the novel tyrosine kinase inhibitors (dasatinib, nilotinib) becoming available through either clinical trials or market approval. This review examines the available data on CML in China, Hong Kong, India, the Philippines, Singapore, South Korea, Taiwan and Thailand.
Au
Wing Y
WY
Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong.
Caguioa
Priscilla B
PB
UST Hospital and St Luke's Medical Center, University of Santo Tomas Faculty of Medicine and Surgery, Manila, The Philippines.
Chuah
Charles
C
Department of Hematology, Singapore General Hospital and Duke-NUS Graduate Medical School, Singapore, Singapore.
Hsu
Szu Chun
SC
Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Jootar
Saengsuree
S
Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand.
Kim
Dong-Wook
DW
Division of Hematology, CML Clinical Research Institute, 3rd floor, St Mary's Hospital, The Catholic University of Korea, 62 Youidodong Youngdeungpogu, 150-713, Seoul, South Korea. dwkim@catholic.ac.kr.
Kweon
Il-Young
IY
Division of Hematology, CML Clinical Research Institute, 3rd floor, St Mary's Hospital, The Catholic University of Korea, 62 Youidodong Youngdeungpogu, 150-713, Seoul, South Korea.
O'Neil
William M
WM
BioMedCom Consultants, Inc., Montreal, QC, Canada.
Saikia
Tapan K
TK
Prince Aly Khan Hospital and Jaslok Hospital, Mumbai, India.
Wang
Jianxiang
J
Department of Clinical Hematology, State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease, Hospital of the Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
D001208:Asia / Q000453:epidemiology; D019008:Drug Resistance, Neoplasm; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000453:epidemiology*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D016896:Treatment Outcome
D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases