Differences in treatment and monitoring of chronic myeloid leukemia with regard to age, but not sex: Results from a population-based study

Eur J Haematol. 2019 Oct;103(4):362-369. doi: 10.1111/ejh.13293. Epub 2019 Aug 28.

Abstract

There are established guidelines for treatment and monitoring of chronic myeloid leukemia (CML) but little is known about routine care. Data on ICD-10 codes as well as prescribed medications were available for 10.5 million patients in the statutory health insurance system in Bavaria for the years 2010 to 2016. Also, data on the molecular and cytogenetic monitoring were integrated. A total of 1714 adult patients with CML were observed. Only 50.8% received more than 67.5 daily doses per quarter year (target: 91.5) while 18.2% did not receive any tyrosine kinase inhibitor (TKI). The median number of daily doses was at least 80 doses per quarter year for all age groups in men, but decreased to 62 doses in elderly women. With this exception, no differences between men and women were observed. The percentage of patients without any TKI increased with age. The median number of molecular examinations was 3.54 independent of age and sex. Even in a highly developed country, still a considerable number of patients with CML seem to not receive adequate treatment, whereas molecular monitoring can be considered satisfactory.

Keywords: chronic myeloid leukemia; health services; monitoring; population-based; prescription.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Disease Management
  • Female
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / epidemiology*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • Male
  • Middle Aged
  • Population Surveillance
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use
  • Treatment Outcome
  • Young Adult

Substances

  • Protein Kinase Inhibitors