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Agarwal MB, John MJ, Jain P, Vaid AK, Bapna A, Basade M, Dattatreya PS, Chakrapani A, Ramanan V, Varadarajan R, Subramanian M, Shah CA, Warrier N, Sanyal S, Ashwin TS, Ramanjinappa N. The Role of Bosutinib in Chronic Myeloid Leukemia: An Indian Perspective. Indian J Med Paediatr Oncol 2022. [DOI: 10.1055/s-0042-1756477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AbstractManagement of chronic myeloid leukemia (CML) has been transformed by the use of tyrosine kinase inhibitors (TKIs). Presently in India, five TKIs are approved for the management of CML with distinct safety profiles. The selection of TKIs for chronic phase (CP)-CML patients is based on treatment goals, underlying comorbidities, and specific TKI toxicity profiles. Bosutinib is one of five TKIs indicated for the first-line treatment of CP-CML and patients with intolerance or resistance to prior TKI therapy. It possesses a distinct safety profile among other TKIs, with less cardiovascular adverse events (AEs), albeit the liver-related and gastrointestinal AEs have higher occurrence. The safety and efficacy of bosutinib have been examined in clinical trials; however, there is a paucity of data from Asia. A virtual expert panel meeting was convened to gather expert opinion from India on the selection of bosutinib as a treatment choice for patients with CP-CML. This is a white paper document drafted with the help of an expert panel of 14 oncologists and hematooncologists from India on bosutinib use in CP-CML. The experts concurred that bosutinib has proven efficacy for CP-CML in global randomized clinical trials and is well suited for CP-CML patients with existing cardiovascular comorbidities. However, it was not recommended for patients with gastrointestinal, pancreatic, or renal abnormalities. This review aims to put forth expert opinion and guidance document on key considerations for CP-CML clinical decision-making in India.
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Affiliation(s)
| | | | - Punit Jain
- Apollo Hospitals, Navi Mumbai, Maharashtra, India
| | | | - Ajay Bapna
- Department of Oncology, Bhagwan Mahaveer Cancer Hospital and Research Center, Jaipur, Rajasthan, India
| | | | | | | | - Vijay Ramanan
- Clinical Hematology, Bone Marrow and Stem Cell Transplant, Yashoda Hematology Clinic, Pune, Maharashtra, India
| | | | | | | | | | | | | | - Nagendra Ramanjinappa
- Mylan Pharmaceuticals Private Limited (A Viatris Company), Prestige Tech Park, Kadubeesanahalli, Bengaluru, Karnataka
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Kesana S, Radhakrishnan V, Kalaiyarasi JP, Mehra N, Selvarajan G, Karunakaran P, Kannan K, Dhanushkodi M, Sundersingh S, Mani S, Ganesan TS, Sagar TG. Real-World Experience of Treating Pediatric Chronic Myeloid Leukemia: Retrospective Study from a Cancer Center in Southern India. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1740951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Introduction Chronic myeloid leukemia (CML) is rare in children and constitutes 2% of all leukemia. We present our institute experience in treating pediatric CML for 20 years.
Objectives There is a paucity of data on pediatric CML from India, hence we would like to present treatment responses and survival rates in our pediatric population treated with tyrosine kinase inhibitors at our center.
Materials and Methods Patients aged less than 18 years, diagnosed with CML from 2000 to 2019, and treated with imatinib were analyzed retrospectively considering demographic features, treatment characteristics, and survival outcomes. Descriptive analysis was done for the baseline characteristics. Event-free survival (EFS) and overall survival (OS) were calculated using the Kaplan-Meier method and the factors were compared using the log-rank test.
Results During the study period, 95 patients were diagnosed with CML of which 54 (56.8%) were males. The most common stage at presentation was the chronic phase (CP) with 84 (88.4%) patients followed by accelerated phase (AP) and blast crisis (BC) with 6 (6.3%) and 5 (5.3%) patients respectively. The median duration of follow-up for all patients was 98 months. EFS and OS at 8 years for patients with CML-CP were 43.1% and 80.4% respectively. Complete hematological response, complete cytogenetic response, and major molecular response was documented in 91 (95.7%), 73 (76.8%), and 63 (66.3%) patients respectively.
Conclusion Outcomes in pediatric CML are comparable to that of adults. Imatinib is well tolerated in children.
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Affiliation(s)
- Sivasree Kesana
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
| | | | | | - Nikita Mehra
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
| | - Gangothri Selvarajan
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
| | - Parathan Karunakaran
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
| | - Krishnarathinam Kannan
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
| | - Manikandan Dhanushkodi
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
| | | | - Samson Mani
- Molecular Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
| | - Trivadi S. Ganesan
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
| | - Tenali Gnana Sagar
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu, India
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Daskalakis M, Feller A, Noetzli J, Bonadies N, Arndt V, Baerlocher GM. Potential to Improve Therapy of Chronic Myeloid Leukemia (CML), Especially for Patients with Older Age: Incidence, Mortality, and Survival Rates of Patients with CML in Switzerland from 1995 to 2017. Cancers (Basel) 2021; 13:6269. [PMID: 34944892 PMCID: PMC8699480 DOI: 10.3390/cancers13246269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Tyrosine kinase inhibitors (TKI) substantially improved chronic myeloid leukemia (CML) prognosis. We aimed to describe time period- and age-dependent outcomes by reporting real-world data of CML patients from Switzerland. METHODS Population-based incidence, mortality, and survival were assessed for four different study periods and age groups on the basis of aggregated data from Swiss Cantonal Cancer Registries. RESULTS A total of 1552 new CML cases were reported from 1995 to 2017. The age-standardized rate (ASR) for the incidence remained stable, while the ASR for mortality decreased by 50-80%, resulting in a five-year RS from 36% to 74% over all four age groups. Importantly, for patients <60 years (yrs), the five-year RS increased only in earlier time periods up to 92%, whereas for older patients (+80 yrs), the five-year RS continued to increase later, however, reaching only 53% until 2017. CONCLUSIONS This is the first population-based study of CML patients in Switzerland confirming similar data compared to other population-based registries in Europe. The RS increased significantly in all age groups over the last decades after the establishment of TKI therapy. Interestingly, we found a more prominent increase in RS of patients with older age at later observation periods (45%) compared to patients at younger age (10%), implicating a greater benefit from TKI treatment for elderly occurring with delay since the establishment of TKI therapy. Our findings suggest more potential to improve CML therapy, especially for older patients.
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Affiliation(s)
- Michael Daskalakis
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland; (J.N.); (N.B.)
- Department of BioMedicalResearch (DMBR), University of Bern, Murtenstrasse 40, 3008 Bern, Switzerland
| | - Anita Feller
- Foundation National Institute for Cancer Epidemiology and Registration (NICER), University of Zurich, Seilergraben 49, 8001 Zurich, Switzerland; (A.F.); (V.A.)
- National Agency for Cancer Registration (NACR) Operated by NICER, University of Zurich, 8001 Zurich, Switzerland
| | - Jasmine Noetzli
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland; (J.N.); (N.B.)
- Cabinet Noetzli, Avenue de Rumine 35, 1005 Lausanne, Switzerland
| | - Nicolas Bonadies
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland; (J.N.); (N.B.)
- Department of BioMedicalResearch (DMBR), University of Bern, Murtenstrasse 40, 3008 Bern, Switzerland
| | - Volker Arndt
- Foundation National Institute for Cancer Epidemiology and Registration (NICER), University of Zurich, Seilergraben 49, 8001 Zurich, Switzerland; (A.F.); (V.A.)
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Gabriela Maria Baerlocher
- Department of BioMedicalResearch (DMBR), University of Bern, Murtenstrasse 40, 3008 Bern, Switzerland
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Chandra D, Singh J, Deka R, Chauhan R, Sazwal S, Mishra P, Seth T, Mahapatra M, Saxena R. The Biology of Chronic Myelogenous Leukemia in Childhood and Young Adolescents: An Indian Perspective. Indian J Med Paediatr Oncol 2021. [DOI: 10.4103/ijmpo.ijmpo_62_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Objective: The purpose of this study was to determine the clinical, biological, and molecular characteristics at diagnosis in children and adolescents with chronic myelogenous leukemia (CML) in the Indian scenario at our tertiary patient care center. Subjects and Methods: We evaluated 51 children and adolescents with CML registered at our clinic, from January 2007 to December 2015. The mean and median of various parameters were calculated using a Microsoft excel sheet and SPSS software version 16. Results: The median age of presentation in children was 16 years; 92.2% of them were older than 10 years, with a higher prevalence in boys than girls (gender ratio 2.6:1). The symptoms at presentation were fatigue, fever, awareness of mass due to splenomegaly, and bleeding manifestations. One patient presented with Bell's palsy. Markedly raised leukocyte counts were present in 29.4% patients (median white blood cell count >400 × 109/L). Most of the patients presented in the chronic phase of the disease, four each were in accelerated phase and blast crisis, respectively. Majority of patients were categorized as intermediate risk as per Sokal and Hansford score. About 60.7% of these pediatric patients fell in low-risk category as per European Treatment and Outcome Study score at baseline. A predominance of transcript P210-b3a2 (68%) was observed in the children who were studied for the type of chimeric BCR-ABL mRNA. Conclusions: This is one of the most recent reported series of CML in children and adolescents from India highlighting the difference in presentation from adults; mainly hepatomegaly, bleeding manifestations, and higher leukocyte count. Presence of b3a3 transcript of p210 breakpoint of BCR-ABL was more common in children (68%) than b2a2 transcript (32%) when compared to adults as recently described in a study from India, which may explain the differences at presentation.
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Affiliation(s)
- Dinesh Chandra
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Jasdeep Singh
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Roopam Deka
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Richa Chauhan
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Sudha Sazwal
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Pravas Mishra
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Tulika Seth
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Manoranjan Mahapatra
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
| | - Renu Saxena
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
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Shruthi PS, Udgire S, Munawalli R, Murugan S. A rare presentation of chronic myeloid leukemia blast crisis. IRAQI JOURNAL OF HEMATOLOGY 2020. [DOI: 10.4103/ijh.ijh_16_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Samal P, Chakrabarti P, Nath UK. A prospective, randomized study to compare the combination of imatinib and cytarabine versus imatinib alone in newly diagnosed patients with chronic phase chronic myeloid leukemia. Indian J Cancer 2019; 56:211-215. [PMID: 31389383 DOI: 10.4103/ijc.ijc_303_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION To compare the efficacy and safety of imatinib and cytarabine (ara-c) combination versus imatinib monotherapy in newly diagnosed patients with chronic phase chronic myeloid leukemia (CML-CP). MATERIALS AND METHODS This prospective, randomized study included adult patients (age >18 years) with newly diagnosed CML-CP. Patients received either a single oral dose of imatinib 400 mg/day in combination with a subcutaneous injection of ara-c 20 mg/m2/day (imatinib + ara-c) or a single oral dose of imatinib 400 mg/day. Primary endpoints were hematological and molecular responses at 3 months and cytogenetic responses at 6 and 12 months. Secondary endpoints included grade 3/4 hematological and nonhematological adverse events (AEs). RESULTS Of 30 patients included, 14 were randomized to imatinib + ara-c and 16 to imatinib alone. Complete hematologic response (CHR) at 3 months was higher with imatinib + ara-c vs. imatinib alone (100% vs. 87.5%, P = 0.48). The median time to achieve CHR was significantly (P < 0.001) lower with imatinib + ara-c (32.07 vs. 23.43 days). Molecular response at 3 months was significantly higher (P = 0.04) with imatinib + ara-c vs. imatinib alone (100% vs. 68.75%). Complete cytogenetic response was also higher with imatinib + ara-c vs. imatinib alone (42.85% vs. 25% at 6 months and 71.4% vs. 62.5% at 12 months). Neutropenia followed by thrombocytopenia and anemia were the most common AEs. Grade 3/4 hematological and nausea events were significantly (P < 0.05) higher with imatinib + ara-c. Other nonhematological events were not significantly different between the treatments. The median follow-up duration was 20 months (range: 15-23 months). CONCLUSION Imatinib with low-dose ara-c can be considered as a potential first-line treatment option for CML-CP.
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Affiliation(s)
- Priyanka Samal
- Institute of Hematology and Transfusion Medicine (IHTM), Kolkata, West Bengal, India
| | - Prantar Chakrabarti
- Institute of Hematology and Transfusion Medicine (IHTM), Kolkata, West Bengal, India
| | - Uttam K Nath
- Institute of Hematology and Transfusion Medicine (IHTM), Kolkata, West Bengal, India
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7
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Yanamandra U, Sahu KK, Karunakaran P, Katoch D, Jain N, Khadwal A, Prakash G, Lad D, Naseem S, Varma N, Varma S, Malhotra P. Adolescent and Young Adult Chronic Myeloid Leukemia in Real-World Settings: Experience from a Tertiary Care Institute in Northern India. J Adolesc Young Adult Oncol 2018; 8:94-97. [PMID: 30383979 DOI: 10.1089/jayao.2018.0007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The data on adolescent and young adult chronic myeloid leukemia (AYA-CML) from the Indian subcontinent are scarce. We studied characteristics of AYA-CML through a retrospective analysis of 1950 CML patients registered to a tertiary care hospital in Northern India. AYA-CML represented 22.1% of all CML patients, with cumulative overall survival (OS) of 84%, and 1 and 8 years OS of 94.2% and 74.2%, respectively. Of all cases, 8.91% patients had advanced disease at the time of diagnosis, and 13.95% had myelofibrosis in the diagnostic marrow, 79.6% had complete cytogenetic response (CCyR), and 84.5% had major molecular response (MMR). Loss of CCyR and MMR was noted in 37.2% and 28.4%, respectively. The cumulative OS was significantly better in patients on patient assistance program, and they were initiated on therapy within 3 months of symptom onset.
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Affiliation(s)
- Uday Yanamandra
- 1 Department of Hematology and Stem Cell Transplant, Army Hospital (Research & Referral), Delhi, India
| | - Kamal Kant Sahu
- 2 Department of Internal Medicine (Clinical Hematology Division), PGIMER, Chandigarh, India
| | - Parathan Karunakaran
- 2 Department of Internal Medicine (Clinical Hematology Division), PGIMER, Chandigarh, India
| | - Deeksha Katoch
- 2 Department of Internal Medicine (Clinical Hematology Division), PGIMER, Chandigarh, India
| | - Nidhi Jain
- 2 Department of Internal Medicine (Clinical Hematology Division), PGIMER, Chandigarh, India
| | - Alka Khadwal
- 2 Department of Internal Medicine (Clinical Hematology Division), PGIMER, Chandigarh, India
| | - Gaurav Prakash
- 2 Department of Internal Medicine (Clinical Hematology Division), PGIMER, Chandigarh, India
| | - Deepesh Lad
- 2 Department of Internal Medicine (Clinical Hematology Division), PGIMER, Chandigarh, India
| | - Shano Naseem
- 3 Department of Hematology, PGIMER, Chandigarh, India
| | - Neelam Varma
- 3 Department of Hematology, PGIMER, Chandigarh, India
| | - Subhash Varma
- 2 Department of Internal Medicine (Clinical Hematology Division), PGIMER, Chandigarh, India
| | - Pankaj Malhotra
- 2 Department of Internal Medicine (Clinical Hematology Division), PGIMER, Chandigarh, India
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8
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Nguyen LT, Guo M, Naugler C, Rashid-Kolvear F. Incidence of chronic myeloid leukemia in Calgary, Alberta, Canada. BMC Res Notes 2018; 11:780. [PMID: 30382890 PMCID: PMC6211485 DOI: 10.1186/s13104-018-3890-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 10/26/2018] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE The epidemiology of chronic myeloid leukemia is shifting due to the aging global population and the recent discovery and availability of targeted treatment options. This study provides recent data regarding the incidence of CML in Calgary, a major Canadian city. Data from patients diagnosed with CML by bone marrow sample analysis from 2011 to 2015 were collected from the database of the sole centralized cytogenetics facility in service of Calgary and its surrounding area. RESULTS With an average of 10.2 newly diagnosed cases per year in Calgary from 2011 to 2015, the incidence rate was calculated to be 0.75 cases per 100,000 person-years (95% CI 0.57-0.99). With age standardization, the incidence was 0.87 cases per 100,000 person-years (95% CI 0.82-0.91) for the Canadian population, which was low compared to other developed Western nations. The highest incidence rates were observed in the older patient categories, however there was a broad age distribution for incident cases and the median age at diagnosis was 48. There was a general male bias for CML most pronounced at the younger ages. Our description of CML incidence will help to inform healthcare planners amidst the dramatically altered treatment of this hematological neoplasm.
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Affiliation(s)
- Leonard Tu Nguyen
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Maggie Guo
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christopher Naugler
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Departments of Family Medicine and Community Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Fariborz Rashid-Kolvear
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Diagnostic and Scientific Centre, 2E-415, 9 3535 Research Road NW, Calgary, AB, T2L2K8, Canada.
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9
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Yanamandra U, Malhotra P, Sahu K, Sushma Y, Saini N, Chauhan P, Gill J, Rikhi D, Khadwal A, Prakash G, Lad D, Suri V, Kumari S, Varma N, Varma S. Variation in Adherence Measures to Imatinib Therapy. J Glob Oncol 2018; 4:1-10. [PMID: 30241224 PMCID: PMC6223484 DOI: 10.1200/jgo.2016.007906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The introduction of tyrosine kinase inhibitors has transformed the care of patients with chronic myeloid leukemia, with survival approaching that of healthy individuals. Current-day challenges in chronic myeloid leukemia care include adherence to tyrosine kinase inhibitor therapy. We studied adherence from resource-constrained settings and tried to analyze the factors responsible for nonadherence in these individuals. We also correlated adherence to current molecular status. PATIENTS AND METHODS This was a single-center, cross-sectional, observational study from north India. It consisted of a questionnaire-based survey in which a one-to-one interview technique was used by trained nursing staff administering the Modified Morisky Adherence Scale (MMAS-9) questionnaire. Adherence was also measured on the basis of physician's assessment. JMP 13.0.0 was used for statistical analysis. RESULTS A total of 333 patients with a median age of 42 years were included in the study. The median BCR-ABL/ABL ratio (IS) was 0.175 (0.0 to 98.0). The mean MMAS-9 score was 11 ± 2. Adherence was seen in 54.95% on the basis of MMAS-9, whereas physician's assessment reported adherence in 90.39% of patients. Using the χ2 test, no relationship was found between the two assessment techniques. There was a significant relationship between major molecular response status and adherence by physician's assessment and MMAS-9 ( P < .001). Bivariate analysis by logistic fit showed a good relation between the MMAS-9 score and the BCR-ABL/ABL ratio (IS), χ2 (1,220) = 135.45 ( P < .001). On multivariate analysis, enrolment in the Novartis Oncology Access program (a patient assistance program) was significantly associated with adherence ( P = .012). CONCLUSION This study highlights the lack of adherence in real-world settings and the various factors responsible. Such studies are important from a public health services perspective in various settings around the world because they may lead to corrective action being taken at the institutional level.
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Affiliation(s)
- Uday Yanamandra
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Pankaj Malhotra
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - K.K. Sahu
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Yanamandra Sushma
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Neha Saini
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Pooja Chauhan
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Jasmeen Gill
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Deepika Rikhi
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Alka Khadwal
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Gaurav Prakash
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Deepesh Lad
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Vikas Suri
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Savita Kumari
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Neelam Varma
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
| | - Subhash Varma
- Uday Yanamandra, Pankaj Malhotra,
K.K. Sahu, Neha Saini, Pooja Chauhan,
Jasmeen Gill, Deepika Rikhi, Alka
Khadwal, Gaurav Prakash, Deepesh Lad,
Vikas Suri, Savita Kumari, Neelam
Varma, and Subhash Varma, Postgraduate Institute of
Medical Education and Research, Chandigarh; and Yanamandra Sushma,
Max Hospital, Mohali, Punjab, India
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Abstract
Background In the last decade, the use of imatinib has brought a paradigm shift in the management of chronic myeloid leukemia (CML). In India, imatinib has been available for more than a decade and has been made accessible to all segments of the population because of patient assistance programs and cheaper generic versions. Despite improvements in survival, there are unique challenges in the Indian context. Methods We reviewed published data pertaining to CML in India for the period of 1990 to 2016, using PubMed advanced search with the terms chronic myeloid leukemia and India, and included studies that reported on epidemiology, monitoring for therapy, treatment outcomes, and resistance. Additionally, the references in retrieved articles were also reviewed. Results Thirty-seven studies were identified. The incidence of CML may be slightly lower in India than in the West, but there was only a single article reporting population-based data. Indian patients presented with more advanced disease. Most centers have access to imatinib as first-line therapy, but there is limited availability of molecular monitoring and second-line therapy. Most of the outcome data were retrospective but seemed comparable with that reported in Western centers. Drug adherence was impaired in at least one third of patients and contributed to poor survival. Conclusion Focused prospective studies and cooperative studies might improve the quality of data available. Future studies should focus on adherence, its effects on outcomes, and methods to address this problem.
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Affiliation(s)
- Prasanth Ganesan
- , Cancer Institute (WIA), Chennai; and , All India Institute of Medical Sciences, New Delhi, India
| | - Lalit Kumar
- , Cancer Institute (WIA), Chennai; and , All India Institute of Medical Sciences, New Delhi, India
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Koyande S, Subramanian S, Edwards P, Hoover S, Deshmane V, Tankga F, Dikshit R, Saraiya M. Economic evaluation of Mumbai and its satellite cancer registries: Implications for expansion of data collection. Cancer Epidemiol 2016; 45 Suppl 1:S43-S49. [PMID: 27726981 PMCID: PMC5847316 DOI: 10.1016/j.canep.2016.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/23/2016] [Accepted: 10/03/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND The Mumbai Cancer Registry is a population-based cancer registry that has been in operation for more than five decades and has successfully initiated and integrated three satellite registries in Pune, Nagpur, and Aurangabad, each covering specific urban populations of the Indian state Maharashtra. Data collectors at the satellites perform data abstraction, but Mumbai carries out all other core registration activities such as data analysis and quality assurance. Each of the three satellite registries follows the same data collection methodology as the main Mumbai Cancer Registry. This study examines the cost of operating the Mumbai and its satellite cancer registries. METHODS We modified and used the Centers for Disease Control and Prevention's (CDC's) International Registry Costing Tool (IntRegCosting Tool) to collect cost and resource use data for the Mumbai Cancer Registry and three satellites. RESULTS Almost 60% of the registration expenditure was borne by the Indian Cancer Society, which hosts the Mumbai Cancer Registry, and more than half of the registry expenditure was related to data collection activities. Across the combined registries, 93% of the expenditure was spent on labor. Overall, registration activities had a low cost per case of 226.10 Indian rupees (or a little less than 4.00 US dollars in 2014 [used average exchange rate in 2014: 1 US $=60 Indian rupees]). CONCLUSION The centralization of fixed-cost activities in Mumbai likely resulted in economies of scale in operating the Mumbai and satellite registries, which, together, report on almost 20,000 cancer cases annually. In middle-income countries like India, where financial resources are limited, the operational framework provided by the Mumbai and satellite registries can serve as a model for other registries looking to expand data collection.
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Affiliation(s)
| | - Sujha Subramanian
- RTI International, 3040 E. Cornwallis Rd., Research Triangle Park, NC, USA.
| | - Patrick Edwards
- RTI International, 3040 E. Cornwallis Rd., Research Triangle Park, NC, USA
| | - Sonja Hoover
- RTI International, 3040 E. Cornwallis Rd., Research Triangle Park, NC, USA
| | | | - Florence Tankga
- Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, USA
| | | | - Mona Saraiya
- Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, USA
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12
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Kumari S, Puneet, Prasad SB, Yadav SS, Kumar M, Khanna A, Dixit VK, Nath G, Singh S, Narayan G. Cyclin D1 and cyclin E2 are differentially expressed in gastric cancer. Med Oncol 2016; 33:40. [DOI: 10.1007/s12032-016-0754-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 03/15/2016] [Indexed: 01/01/2023]
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13
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Thielen N, Visser O, Ossenkoppele G, Janssen J. Chronic myeloid leukemia in the Netherlands: a population-based study on incidence, treatment, and survival in 3585 patients from 1989 to 2012. Eur J Haematol 2015; 97:145-54. [PMID: 26519944 DOI: 10.1111/ejh.12695] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2015] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To assess the impact and results of treatment of CML in the general population, we conducted a population-based, nationwide study on 3585 CML patients diagnosed between 1989 and 2012 in the Netherlands. METHODS Patient demographics were obtained from the Netherlands Cancer Registry. Information on age, gender, year of diagnosis, first treatment, and date of death were recorded. Overall survival (OS) was adjusted for death rates in the normal population. RESULTS Incidence in males decreased slightly from 1.2 per 100.000 person years (PY) in 1989-2000 to 0.9 in 2001-2012. For females, incidence remained stable with 0.7 per 100.000 PY in both periods. Incidence was age dependent and highest in males in the last decades of life. Treatment before 2000 mainly consisted of chemotherapy, while after 2007 TKI use was 88%. Five-year relative survival was only 36% before the introduction of TKIs but significantly increased to 79% after the introduction of TKI. CONCLUSIONS This study gives insight into CML incidence, treatment, and survival in routine care in the Netherlands. Although OS improved since the introduction of TKIs, there is still room for further improvement.
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Affiliation(s)
- Noortje Thielen
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
| | - Otto Visser
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Gert Ossenkoppele
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
| | - Jeroen Janssen
- Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands
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14
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Ghalaut VS, Prakash G, Bansal P, Dahiya K, Dokwal S, Ghalaut PS, Bala M, Dhankhar R. Effect of imatinib on male reproductive hormones in BCR-ABL positive CML patients: A preliminary report. J Oncol Pharm Pract 2014; 20:243-8. [PMID: 23966360 DOI: 10.1177/1078155213500686] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Multiple animal studies, few clinical case reports and one study have observed decreased testosterone production and gynaecomastia as adverse effect of imatinib therapy. We have prospectively studied testosterone, LH and FSH levels at baseline and at 6 months of imatinib treatment in 34 newly diagnosed male BCR-ABL positive CML patients. While none of the patients had gynaecomastia at 6 months, the proportion of patients with low testosterone level increased significantly from 11.8% at baseline to 58.8% (p < 0.001) and those with high LH and FSH increased significantly from 26.4% and 23.5% to 82.4% and 76.4%, respectively (p < 0.001 and p < 0.001). Serum testosterone levels decreased significantly (p = 0.002) and serum LH and FSH levels increased significantly at 6 months of imatinib therapy (p = 0.001 and p = 0.003) in comparison to baseline levels. The findings document the effect of imatinib on testosterone levels in adult CML patients much before than reported earlier.
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Affiliation(s)
- Veena S Ghalaut
- Department of Biochemistry, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Gulshan Prakash
- Department of Biochemistry, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Piyush Bansal
- Department of Biochemistry, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Kiran Dahiya
- Department of Biochemistry, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Sumit Dokwal
- Department of Biochemistry, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Pratap S Ghalaut
- Department of Medicine, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Manju Bala
- Department of Biochemistry, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
| | - Rakesh Dhankhar
- Department of Radiotherapy, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India
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Raut L, Bohara VV, Ray SS, Chakrabarti P, Chaudhuri U. Chronic myeloid leukemia in children and adolescents: A single center experience from Eastern India. South Asian J Cancer 2014; 2:260-4. [PMID: 24455654 PMCID: PMC3889057 DOI: 10.4103/2278-330x.119891] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Context: Chronic Myeloid Leukemia (CML) constitutes around 3% of leukemia in the children and adolescent age group. Aims: The aim of the study was to evaluate the characteristics at presentation and the treatment outcome of CML in the children and adolescent age group. Settings and Design: Retrospective analysis was carried out at a single center in India. Materials and Methods: Thirteen patients (≤17 years) attending CML outdoor from April 2008 to August 2012 were included in the analysis. Statistical Analysis Used: The mean and median of various parameters were calculated using a Microsoft excel sheet. SPSS 16.0 version software was used to calculate OS and PFS. Results: CML-CP was the most common phase at presentation. Maximum patients belonged to the 14 - 17 year old age group. Disease was common in the male sex. Splenic discomfort and asthenia were the most common symptoms and splenomegaly was the most common sign. Conclusions: The treatment with Imatinib was effective and well-tolerated.
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Affiliation(s)
- Lalit Raut
- Institute of Hematology and Transfusion Medicine, Medical College and Hospital, Kolkata, West Bengal, India
| | - Vinay V Bohara
- Institute of Hematology and Transfusion Medicine, Medical College and Hospital, Kolkata, West Bengal, India
| | - Siddhartha S Ray
- Institute of Hematology and Transfusion Medicine, Medical College and Hospital, Kolkata, West Bengal, India
| | - Prantar Chakrabarti
- Institute of Hematology and Transfusion Medicine, Medical College and Hospital, Kolkata, West Bengal, India
| | - Utpal Chaudhuri
- Institute of Hematology and Transfusion Medicine, Medical College and Hospital, Kolkata, West Bengal, India
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16
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Moore MA. Overview of Cancer Registration Research in the Asian Pacific from 2008-2013. Asian Pac J Cancer Prev 2013; 14:4461-84. [DOI: 10.7314/apjcp.2013.14.8.4461] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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