Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Uludağ University, Bursa, Turkey.
Expert Rev Hematol. 2022 Feb;15(2):97-106. doi: 10.1080/17474086.2022.2044779. Epub 2022 Mar 4.
The therapeutic landscape of chronic myeloid leukemia (CML) has evolved significantly since the introduction of imatinib. The European LeukemiaNet (ELN) recommendations serve as a guide for diagnosis, treatment, and monitorization of CML, but availability and accessibility of diagnostic tools and medications affect their applicability.
This article provides an overview of the current clinical management of CML in Turkey with reference to the key outputs of the online expert meeting held in November 2020. The applicability of the ELN 2020 recommendations for treating CML in clinical practice was also discussed.
Imatinib is the only reimbursed and the most preferred first-line treatment in CML restricting the upfront use of second-generation tyrosine kinase inhibitors (TKIs), thereby limiting the applicability of treatment-free remission approach in Turkey. The ELN recommendations about using the EUTOS Long-Term Survival (ELTS) score for risk assessment and focusing on patient reported outcomes and quality of life can be enhanced with educational activities. The widespread availability of standardized technical infrastructure for diagnosing and monitoring CML will contribute to better disease management. Establishing a sustainable national database for CML is valuable for observing patient characteristics and disease outcomes as well as the impact of treatment patterns over time.
自伊马替尼问世以来，慢性髓性白血病（CML）的治疗领域发生了重大变化。欧洲白血病网络（ELN）的建议为 CML 的诊断、治疗和监测提供了指导，但诊断工具和药物的可及性会影响其适用性。
本文参考 2020 年 11 月在线专家会议的关键成果，概述了土耳其目前 CML 的临床管理情况。还讨论了 ELN 2020 年建议在临床实践中治疗 CML 的适用性。
伊马替尼是唯一可报销且最受青睐的 CML 一线治疗药物，限制了第二代酪氨酸激酶抑制剂（TKI）的早期使用，从而限制了土耳其无治疗缓解方法的适用性。可以通过教育活动增强 ELN 关于使用 EUTOS 长期生存（ELTS）评分进行风险评估以及关注患者报告的结果和生活质量的建议。用于诊断和监测 CML 的标准化技术基础设施的广泛可用性将有助于更好地进行疾病管理。为 CML 建立一个可持续的国家数据库对于观察患者特征和疾病结果以及随时间推移的治疗模式的影响是有价值的。
