Evaluation of physician guideline adherence and areas for improvement in managing patients with chronic myeloid leukemia: a cross-sectional survey

Abstract

The experience of a physician at a clinical center is among the critical factors in managing chronic myeloid leukemia (CML) during its treatment with tyrosine kinase inhibitors (TKIs). The authors conducted a cross-sectional questionnaire to investigate barriers to physician use of published evidence-based guidelines in CML management in a real-world setting. Among the participating physicians (N = 407), 99.8% of physicians reported that CML guidelines were useful; however, only 62.9% of physicians reported that they follow guidelines in real-time. Although 90.7% of physicians prefer second-generation TKIs as the first-line treatment, imatinib (88.2%) remains the most widely administered TKI in the first-line setting. Only 50.6% of physicians switched the treatment when patients failed to achieve early molecular response (at 3 months), whereas 70.3% of physicians switched the treatment when patients’ response to TKI was inadequate at 6 months and/or 12 months. Moreover, only 43.5% of physicians considered treatment-free remission (TFR) as one of the top 3 goals for their patients. The major concern to obtain TFR was patients’ adherence. This study demonstrated that CML management was generally in line with the current guidelines, but some of the details at the point of care are needed to be improved in CML.

Keywords:

• Chronic myeloid leukemia
• first-line treatment
• early switching
• treatment-free remission

Author contributions

All authors contributed to the design of the study and interpretation of the data. Y.Z, Y.J., L.L., S.C., X.X., X.Z., H.L., Z.H., Q.W., X.Z., H.Q., and W.L. contributed to the data collection. H.C. and N.X. contributed to writing the original draft and data analysis. X.L., W.L., and X.N critically revised the draft manuscript. All authors have read and approved the final content.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by the Natural Science Foundation of Guangdong Province, China [2020A1515010409, 2022A1515011043] and the Key Basic Research Project of Guangzhou City-Basic, and The Applied Basic Research Program of Science, China [202201011781].