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Practice Patterns of Physician Treatment for Pediatric Chronic Myelogenous Leukemia. Biol Blood Marrow Transplant 2019 02;25(2):321-327

Date

09/30/2018

Pubmed ID

30267760

DOI

10.1016/j.bbmt.2018.09.029

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.

Author List

Andolina JR, Burke MJ, Hijiya N, Chaudhury S, Schultz KR, Roth ME

Author

Michael James Burke MD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Bone Marrow Transplantation
Canada
Child
Child, Preschool
Female
Humans
Infant
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Male
Medical Oncology
Practice Guidelines as Topic
Practice Patterns, Physicians'
Siblings
Transplantation, Homologous
United States
Unrelated Donors
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a