Diagnosis and management of chronic myeloid leukemia: a survey of American and European practice patterns.

BACKGROUND: The success of imatinib therapy for chronic myeloid leukemia (CML) has brought new challenges; these include optimizing disease monitoring, imatinib resistance, and use of novel, more potent tyrosine kinase inhibitors. Thus, there is a need to establish new best practices for CML management in the post-imatinib era. METHODS: An internet-based questionnaire, consisting of 26 multiple choice questions, was developed to assess hematologists' and oncologists' self-reported treatment strategies for CML. RESULTS: Between November 2005 and January 2006, 956 eligible physicians responded to the survey; 727 from the US and 229 from Europe. Most US respondents (60%) practiced in the community setting, whereas European respondents were primarily academic (44%) and hospital-based (40%). Physicians' responses were generally in line with current recommendations, although differences were identified. Confusion existed among respondents over optimal timing of treatment decisions, with a notable proportion of physicians focusing on a single timepoint rather than consistent monitoring, as currently advocated. Some respondents were unaware of new molecular monitoring techniques, when to monitor for BCR-ABL mutations (and the impact on treatment decisions), and the benefit of new tyrosine kinase inhibitors. CONCLUSIONS: Responses to the survey suggest that treatment practices in some areas of CML management are not in line with current recommendations. Identified areas of need should be targeted in future educational activities for the CML community. (c) 2007 American Cancer Society.