Practice Patterns of Physician Treatment for Pediatric Chronic Myelogenous Leukemia

Jeffrey R. Andolina*, Michael J. Burke, Nobuko Hijiya, Sonali Chaudhury, Kirk R. Schultz, Michael E. Roth

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Chronic myelogenous leukemia (CML) is a rare disease in children for which pediatric evidence-based guidelines are lacking. We designed an anonymous survey for practicing pediatric oncologists and bone marrow transplantation (BMT) physicians to assess their willingness to recommend BMT for a patient with CML based on various clinical scenarios. A total of 274 physicians responded to the survey (13.4% response rate). Nearly all pediatric oncologists and BMT physicians recommended against BMT at time of diagnosis of CML in the chronic phase, with only 8.0% and 1.9% recommending BMT if a matched sibling donor (MSD) and a matched unrelated donor (MUD), respectively, was available. Similarly, after a first poor response to tyrosine kinase inhibitor (TKI) therapy or hematologic relapse, physicians continued to recommend against BMT (39.5% and 23.3% recommended BMT in patients with a matched sibling donor and matched unrelated donor, respectively). However, 81.7% and 69.8% of respondents would recommend BMT after 2 hematologic relapses on TKI therapy, if an MSD and an MUD, respectively, were available. In addition, there was great interest in developing a clinical trial evaluating the safety and efficacy of stopping TKIs in children with CML who achieve and maintain a deep molecular response, with 86.7% of respondents stating they would offer such a trial to their pediatric patients. This survey highlights the need for evidence-based, pediatric-specific guidelines for the management of children and adolescents with CML.

Original languageEnglish (US)
Pages (from-to)321-327
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume25
Issue number2
DOIs
StatePublished - Feb 2019

Keywords

  • Bone marrow transplantation
  • Chronic myelogenous leukemia
  • Pediatric
  • Tyrosine kinase inhibitor

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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