Chronic myeloid leukemia in Asia

Chronic myeloid leukemia (CML) in Asia has an incidence rather lower than in Western countries yet tends to afflict a younger population. As in the West, imatinib mesylate (IM, Glivec) has supplanted busulphan, hydroxyurea and interferon-α as first-line treatment. Its use has resulted in a dramatic...

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Bibliographic Details
Published in:International journal of hematology 2009-01, Vol.89 (1), p.14-23
Main Authors: Au, Wing Y., Caguioa, Priscilla B., Chuah, Charles, Hsu, Szu Chun, Jootar, Saengsuree, Kim, Dong-Wook, Kweon, Il-Young, O’Neil, William M., Saikia, Tapan K., Wang, Jianxiang
Format: Article
Language:English
Subjects:
Asia - epidemiology
Biological and medical sciences
Drug Resistance, Neoplasm
Hematologic and hematopoietic diseases
Hematology
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - epidemiology
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Medical sciences
Medicine
Medicine & Public Health
Oncology
Protein Kinase Inhibitors - adverse effects
Protein Kinase Inhibitors - therapeutic use
Protein-Tyrosine Kinases - antagonists & inhibitors
Review Article
Treatment Outcome
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Summary:Chronic myeloid leukemia (CML) in Asia has an incidence rather lower than in Western countries yet tends to afflict a younger population. As in the West, imatinib mesylate (IM, Glivec) has supplanted busulphan, hydroxyurea and interferon-α as first-line treatment. Its use has resulted in a dramatic decline in the number of hematopoietic stem cell transplantations (HSCT) performed. Although it is expensive, IM induces a complete cytogenetic response in 60–90% of newly diagnosed patients, and up to 10% for those in blastic phase. The standard dose of 400 mg is well tolerated by most patients, although adverse events have been observed, including drug-induced cytopenia. Through the Glivec International Patient Assistance Program, the majority of CML patients has access to IM and can expect prolonged survival, even in the absence of HSCT. However, just as in Western countries, resistance to imatinib has emerged in Asian countries. They will require the novel tyrosine kinase inhibitors (dasatinib, nilotinib) becoming available through either clinical trials or market approval. This review examines the available data on CML in China, Hong Kong, India, the Philippines, Singapore, South Korea, Taiwan and Thailand.
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-008-0230-0