Suttorp Meinolf, Metzler Markus, Millot Frédéric
Pediatric Hemato-Oncology, Medical Faculty, Technical University Dresden, Dresden D-01307, Germany.
Pediatric Oncology and Hematology, Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen D-9105, Germany.
World J Clin Oncol. 2020 Jun 24;11(6):308-319. doi: 10.5306/wjco.v11.i6.308.
Chronic myeloid leukemia (CML) in minors is a rare disease which can be effectively treated by tyrosine kinase inhibitors (TKIs) since the year 2000. A majority of pediatricians will encounter one or two CML patients in the course of their careers and will typically have to rely on written information along with their own intuition to provide care. Knowledge of response to TKIs and of age-specific side effects has an impact on the design of pediatric CML trials in many ways aiming to contribute toward greater predictability of clinical improvements. Information from a registry on a rare disease like CML offers the enormous benefit of enabling treating physicians to interact and share their collective experience. The International Registry on Pediatric CML (IR-PCML) was founded at Poitiers/France almost 10 years ago. Since then, the number of collaboration centers and in parallel of registered patients continuously increased (> 550 patients as of December 2019). Ideally, from a given treatment center in a country data are transferred to a national coordinator who interacts with the IR-PCML. In the sense of quality assurance, the registry can offer dissemination of knowledge on state-of-the-art diagnostics (including reference appraisal), optimal treatment approaches, and follow-up procedures within a network that is exerting its strength participation. With continuous growth during the recent years, very rare subgroups of patients could be identified (., CML diagnosed at age < 3 years, children presenting with specific problems at diagnosis or during course of treatment) which had not been described before. Publications coming from the IR-PCML disseminated this useful information derived from patients who robustly participate and share information about their disease, among themselves and with their caregivers and clinicians. Patient input driving the collection of data on this rare leukemia is the basis for the considerable success of bringing new therapeutics into clinical use.
自2000年以来,儿童慢性髓性白血病(CML)是一种可用酪氨酸激酶抑制剂(TKIs)有效治疗的罕见疾病。大多数儿科医生在其职业生涯中会遇到一两名CML患者,通常不得不依靠书面信息以及自身直觉来提供治疗。对TKIs反应及特定年龄副作用的了解在许多方面影响着儿童CML试验的设计,旨在提高临床改善的可预测性。来自CML等罕见病登记处的信息具有巨大优势,能使治疗医生相互交流并分享集体经验。国际儿童CML登记处(IR-PCML)于近10年前在法国普瓦捷成立。从那时起,协作中心的数量以及登记患者的数量都在持续增加(截至2019年12月超过550名患者)。理想情况下,来自一个国家特定治疗中心的数据会传输给与IR-PCML互动的国家协调员。从质量保证的角度来看,该登记处能够在一个通过参与发挥其优势的网络内传播有关最新诊断(包括参考评估)、最佳治疗方法和随访程序的知识。随着近年来的持续发展,可以识别出非常罕见的患者亚组(例如,3岁以下诊断为CML的患者、诊断时或治疗过程中出现特定问题的儿童),这些亚组此前未曾被描述过。来自IR-PCML的出版物传播了这些源自积极参与并分享自身疾病信息的患者的有用信息,这些患者之间以及与他们的护理人员和临床医生进行了信息共享。患者输入推动了这种罕见白血病数据的收集,这是新疗法成功应用于临床的重要基础。