Abstract:
INTRODUCTION: Chronic myeloid leukaemia (CML) is a chronic
myeloproliferative disorder characterised by a chromosomal
translocation between the long arms of chromosomes 9 and 12
resulting in the formation of the BCR-ABL fusion gene. The
management of CML has undergone major changes over the past
decade. Novel treatment approaches have had a dramatic impact
on patient outcomes and survival. Nevertheless, these outcomes
can only be achieved in the context of expert management,
careful monitoring of disease response, appropriate management of
adverse events and timeous adjustments to therapy when responses
are not achieved within stated time frames.
AIM: With the advent of novel treatments providing molecular
responses, both the monitoring and management of CML have
become more complicated. The aim of these recommendations was
to provide a pragmatic yet comprehensive roadmap to negotiate
these complexities.
METHODS: Recommendations were developed based on local
expert opinion from both the academic and private medical care
arenas after careful review of the relevant literature and taking
into account the most widely used international guidelines. About
five meetings were held at which these recommendations were
discussed and debated in detail.
RESULTS: A comprehensive set of recommendations was compiled
with an emphasis on diagnosis, investigation, treatment and
monitoring of disease. Careful attention was given to circumstances
unique to South Africa, funding constraints, availability and access
to laboratory resources, as well as the effects of concurrent HIV
infection.
CONCLUSION: Most patients with CML can live a reasonably
normal life if their disease is appropriately managed. These
recommendations should be of value to all specialists involved in
the treatment of haematological disorders.
