Management of chronic myeloid leukaemia in clinical practice in France: results of the French subset of patients from the UNIC study.
OBJECTIVE
To assess real-life treatment practices with imatinib for chronic-phase chronic myeloid leukaemia (CP-CML) in France.


METHODS
In the observational 'Unmet Needs in CML' (UNIC) study of CML management in Europe, case report forms were completed retrospectively for eligible patients (> or =18 years of age, currently treated for CML) during enrolment (September 2006-March 2007). Results from the subset of patients from France are presented.


METHODS
Primary objectives were to estimate from the collected data the proportions of patients ever treated with imatinib and those experiencing imatinib resistance and/or intolerance as determined by physicians' diagnoses of resistance/intolerance leading to a change in imatinib use. Collected data were analysed descriptively. Secondary descriptive measures included imatinib dose modifications and methods for treatment response monitoring.


RESULTS
Of the 654 French CP-CML patients, 95.9% had received imatinib. Of these, 15% were judged by physicians as imatinib-resistant and 31% as imatinib-intolerant (not mutually exclusive) during treatment, 44% required dose modification and 23% discontinued imatinib. In the 12 months preceding the last observation, 65% had a cytogenetic features analysis and 93% had a polymerase chain reaction (PCR) assessment of molecular response. Importantly, and contrasting with European recommendations, 46% of imatinib-resistant patients had never been assessed for BCR-ABL mutations.


CONCLUSIONS
The observational study design limits data collection and interpretation. The findings are specific to the French healthcare system and may not apply to other countries.


CONCLUSIONS
This observational study of CP-CML management in France confirmed that most patients are treated with imatinib, a treatment widely recognised as efficacious. The study highlights opportunities for optimising CML management, as a proportion of patients may require alternative treatment strategies due to imatinib resistance/intolerance. Response monitoring rates differ from recommendations, representing another opportunity for improving care for CP-CML patients through early identification of patients failing current therapy.
Michallet
Mauricette
M
Hospices Civils de Lyon, 5 pl Arsonval, Lyon 69437, France. mauricette.michallet@chu-lyon.fr
Tulliez
Michel
M
Corm
Sélim
S
Gardembas
Martine
M
Huguet
Françoise
F
Oukessou
Abderrahim
A
Bregman
Bruno
B
Vekhoff
Anne
A
Ghomari
Kamel
K
Cambier
Nathalie
N
Guerci-Bresler
Agnès
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D005260:Female; D005602:France; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011364:Professional Practice / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055815:Young Adult