title: Current patient management of chronic myeloid leukemia in Latin America: a study by the Latin American Leukemia Net (LALNET).
abstract: BACKGROUND
  Treatment recommendations have been developed for management of patients with chronic myeloid leukemia (CML).
  
  
  METHODS
  A 30-item multiple-choice questionnaire was administered to 435 hematologists and oncohematologists in 16 Latin American countries. Physicians self-reported their diagnostic, therapeutic, and disease management strategies.
  
  
  RESULTS
  Imatinib is available as initial therapy to 92% of physicians, and 42% of physicians have access to both second-generation tyrosine kinase inhibitors. Standard-dose imatinib is the preferred initial therapy for most patients, but 20% would manage a young patient initially with an allogeneic stem cell transplant from a sibling donor, and 10% would only offer hydroxyurea to an elderly patient. Seventy-two percent of responders perform routine cytogenetic analysis for monitoring patients on therapy, and 59% routinely use quantitative polymerase chain reaction. For patients who fail imatinib therapy, 61% would increase the dose of imatinib before considering change to a second-generation tyrosine kinase inhibitor, except for patients aged 60 years, for whom a switch to a second-generation tyrosine kinase inhibitor was the preferred choice.
  
  
  CONCLUSIONS
  The answers to this survey provide insight into the management of patients with CML in Latin America. Some deviations from current recommendations were identified. Understanding the treatment patterns of patients with CML in broad population studies is important to identify needs and improve patient care.
authors.affiliation: Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. jcortes@mdanderson.org
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
authors.forename: Carmino
authors.initials: C
authors.lastname: De Souza
authors.forename: Manuel
authors.initials: M
authors.lastname: Ayala-Sanchez
authors.forename: Israel
authors.initials: I
authors.lastname: Bendit
authors.forename: Carlos
authors.initials: C
authors.lastname: Best-Aguilera
authors.forename: Alicia
authors.initials: A
authors.lastname: Enrico
authors.forename: Nelson
authors.initials: N
authors.lastname: Hamerschlak
authors.forename: Katia
authors.initials: K
authors.lastname: Pagnano
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pasquini
authors.forename: Luis
authors.initials: L
authors.lastname: Meillon
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001549:Benzamides; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D000068877:Imatinib Mesylate; D007843:Latin America; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians'; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*; D059039:Standard of Care; D011795:Surveys and Questionnaires; D017211:Treatment Failure
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate