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Real-Life Management of Children and Adolescents with Chronic Myeloid Leukemia: The Italian Experience. | LitMetric

AI Article Synopsis

  • - The study examines adherence to treatment guidelines for children with chronic myeloid leukemia (CML) in chronic phase (CP) since no prior data existed on this topic.
  • - Guidelines for treatment with imatinib mesylate (IM) have been shared among pediatric and adult referral centers in Italy, with significant monitoring practices varying between these centers.
  • - Findings indicate that, while the use of specific guidelines is crucial for managing childhood CML, there have been inconsistencies in adherence, particularly before 2009 when some patients underwent unnecessary transplantations.

Article Abstract

Background: To date, no data on the adherence to specific guidelines for children with chronic myeloid leukemia (CML) in chronic phase (CP) have been reported.

Methods: Since 2001, guidelines for treatment with imatinib mesylate (IM) and monitoring in patients younger than 18 years with CP-CML have been shared with 9 pediatric referral centers (P centers) and 4 reference centers for adults and children/adolescents (AP centers) in Italy. In this study, the adherence to these guidelines was analyzed.

Results: Thirty-four patients with a median age of 11.4 years and 23 patients with a median age of 11.0 years were managed at 9 P and at 4 AP centers, respectively. Evaluations of bone marrow (BM) and/or peripheral blood (PB) were available for more than 90% of evaluable patients. Cytogenetics and molecular monitoring of PB were more consistently performed in AP centers, whereas molecular analysis of BM was carried out more frequently in P centers. Before 2009, some patients who responded to IM underwent a transplantation, contrary to the guidelines' recommendations.

Conclusions: Our experience shows that having specific guidelines is an important tool for an optimal management of childhood CP-CML, together with exchange of knowledge and proactive discussions within the network.

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Source
http://dx.doi.org/10.1159/000491546DOI Listing

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