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- Title
The reality of cancer treatment in a developing country: the effects of delayed TKI treatment on survival, cytogenetic and molecular responses in chronic myeloid leukaemia patients.
- Authors
Kurtovic‐Kozaric, Amina; Hasic, Azra; Radich, Jerald P.; Bijedic, Vildan; Nefic, Hilada; Eminovic, Izet; Kurtovic, Sabira; Colakovic, Ferida; Kozaric, Mirza; Vranic, Semir; Bovan, Nada S.
- Abstract
Cancer patients in developing and low-income countries have limited access to target therapies. For example, tyrosine kinase inhibitor ( TKI) therapy for chronic myeloid leukaemia patients ( CML) is often delayed. In Bosnia, 16% of patients received immediate TKI treatment (<3 months of diagnosis), while 66% of patients received therapy after a median 14-month wait period. To assess the effect of delayed treatment on outcome, three patient groups were studied according to the time they received TKI treatment (0-5 months, 6-12 months and >13 months delay). The primary endpoints were complete cytogenetic ( CCyR) and major molecular response ( MMR) at 12 months. At 12 months of therapy, CCyR and MMR rates on imatinib decreased significantly: CCyR was achieved in 67% of patients in the immediate imatinib treatment group, 18% of patients in 6-12 months group and 15% of patients in >13 months wait group. MMR rates at 12 months occurred in 10% of patients with immediate treatment, 6% of those in 6-12 months group and 0% of patients in >13 months wait group. However, CCyR and MMR rates in patients on nilotinib were not associated with duration of treatment delay. Our data suggests that the deleterious effect of a prolonged TKI therapy delay may be ameliorated by the more active TKI nilotinib.
- Subjects
TREATMENT of chronic myeloid leukemia; PROTEIN-tyrosine kinase inhibitors; CYTOGENETICS; DRUG therapy; IMATINIB; NILOTINIB; HEALTH outcome assessment; PUBLIC health in developing countries; THERAPEUTICS
- Publication
British Journal of Haematology, 2016, Vol 172, Issue 3, p420
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.13843