title: Patient characteristics and treatment patterns in chronic myeloid leukemia: evidence from a multi-country retrospective medical record chart review study.
abstract: We conducted a retrospective medical record review of 1,063 patients to examine patient characteristics and treatment patterns among adults with Philadelphia chromosome and/or BCR-ABL-positive chronic-phase chronic myeloid leukemia in the USA, UK, Germany, and Japan. Patients who were included received first-line treatment with imatinib between 1 January 2005 and 31 December 2009 and were not enrolled in a randomized clinical trial between first-line treatment initiation and end of recorded follow-up. The average age was 55 years; 60% were male. On average, patients were initiated on imatinib 2.7 months post-diagnosis and received therapy for 22 months [19 months (USA) to 25 months (Japan)], at a median dose of 400 mg/day. Thirteen percent [8% (Japan) to 16% (UK)] had dose escalation to a median 800 mg/day. Twenty-nine percent discontinued imatinib, primarily due to resistance or disease progression. Among 148 patients receiving second-line dasatinib and 113 receiving nilotinib, a greater proportion in the USA and Germany received nilotinib (54% in each country), while fewer patients in Japan and the UK received nilotinib (47 and 17%, respectively). On average, patients had second-line therapy initiated 25 months post-diagnosis and received treatment for 11 months (dasatinib) or 8 months (nilotinib). Patients initiating dasatinib had more advanced disease than those initiating nilotinib.
authors.affiliation: RTI Health Solutions, 200 Park Offices Drive, Research Triangle Park, NC 27709, USA. mitra@rti.org
authors.forename: Debanjali
authors.initials: D
authors.lastname: Mitra
authors.forename: Peter C
authors.initials: PC
authors.lastname: Trask
authors.forename: Shrividya
authors.initials: S
authors.lastname: Iyer
authors.forename: Sean D
authors.initials: SD
authors.lastname: Candrilli
authors.forename: James A
authors.initials: JA
authors.lastname: Kaye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007564:Japan; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D016896:Treatment Outcome; D006113:United Kingdom; D014481:United States; D055815:Young Adult