title: Molecular monitoring of tyrosine kinase inhibitor therapy of chronic myeloid leukemia in China.
abstract: OBJECTIVE
  Explore molecular monitoring patterns of patients with chronic myeloid leukemia (CML) on tyrosine kinase inhibitors therapy in China and identify variables associated with monitoring patterns.
  
  
  METHODS
  Non-interventional, cross-sectional study using questionnaires distributed to persons with CML and answered anonymously.
  
  
  RESULTS
  A total of 819 respondents in chronic phase outside clinical trials were evaluable; 477 respondents (58 %) were male. Median age was 41 years (range 18-88 years). A total of 609 (74 %) respondents received a TKI <1 year after diagnosis and 665 (81 %) were on a branded TKI. Median TKI therapy duration was 3 years (range <1-13 years). A total of 255 (31 %) respondents had a molecular test every 3 months, and 280 (34 %), every 6 months. Multivariate analyses showed that older age, starting TKI therapy >1 year after diagnosis and generic TKI use were associated with deviation from recommended monitoring frequency (both every 3 months and every 3 or 6 months). In addition, TKI therapy duration >3 years and imatinib use were associated with under-testing every 3 months. Rural household registration was associated with less testing at every 3 or 6 months. The most commonly stated reasons for under-testing were no requirement by physician (60 %), followed by cost (19 %), no necessity (10 %) and no eligible lab nearby (10 %).
  
  
  CONCLUSIONS
  Many Chinese with chronic phase CML receiving TKI therapy do not have response monitoring compliant with recommended guidelines. Older age, financial burden and physician non-adherence to guideline recommendations are associated with low monitoring frequencies.
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, No. 11 Xizhimen South Street, Beijing, 100044, China. jiangqian@medmail.com.cn.|Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China. jiangqian@medmail.com.cn.
authors.forename: Qian
authors.initials: Q
authors.lastname: Jiang
authors.affiliation: Division of Experimental Medicine, Department of Medicine, Haematology Research Centre, Imperial College London, London, UK.
authors.forename: Robert Peter
authors.initials: RP
authors.lastname: Gale
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002681:China; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases
keywords: BCR–ABL; Chronic myeloid leukemia; Guidelines; Imatinib; Molecular monitoring; Tyrosine kinase inhibitors