A Ten-Year Experience of Treating Chronic Myeloid Leukemia in Rural Rwanda: Outcomes and Insights for a Changing Landscape.
Jennifer MorganRebecca J DeBoerJean Bosco BigirimanaCam NguyenDeogratias RuhangazaAlan PaciorekFred MugaboChandler VillaverdeNicaise NsabimanaPascal BihizimanaAline UmwizerwaLeslie E LehmannLawrence N ShulmanCyprien ShyiramberePublished in: JCO global oncology (2022)
Coupling molecular diagnostics with affordable access to imatinib within a comprehensive cancer care delivery program is a successful long-term strategy to treat CML in resource-constrained settings. Our patients are younger and have higher rates of imatinib resistance compared with historic cohorts in high-income countries. High imatinib resistance rates highlight the need for access to molecular monitoring, resistance testing, and second-generation tyrosine kinase inhibitors, as well as systems to support drug adherence. Hematologic response is an accurate resource-adapted predictor of survival in this setting. Local diagnostic capacity development has allowed for continuous, timely CML care delivery in Rwanda.
Keyphrases
- chronic myeloid leukemia
- end stage renal disease
- ejection fraction
- quality improvement
- healthcare
- newly diagnosed
- chronic kidney disease
- palliative care
- peritoneal dialysis
- emergency department
- single molecule
- prognostic factors
- mental health
- adipose tissue
- high resolution
- skeletal muscle
- patient reported outcomes
- insulin resistance
- pain management
- glycemic control
- room temperature
- affordable care act
- chronic pain
- ionic liquid