Analysis of CML treatment outcomes in Ukraine
Summary. Objective. To evaluate the efficacy of tyrosine kinase inhibitor (TKI) therapy in patients with chronic myeloid leukemia (CML) in Ukraine, determine the proportion of resistant patients, and characterize regional differences in therapeutic approaches. Materials and methods. Data from a survey of health departments across 22 Ukrainian regions (June–July 2024) were analyzed, covering the number of registered CML patients, distribution by therapy line, and rates of resistance to TKIs of different generations. Real-world clinical practice was summarized with consideration of regional differences. Results. As of July 1, 2024, 2,034 CML patients were registered in Ukraine. First-line TKI therapy (imatinib) was received by 63% of patients, and second-line TKIs (nilotinib, dasatinib, bosutinib) by 32%. The average resistance rate to first-line therapy across Ukraine was 19.15%, and to second-line therapy 4.55%, consistent with international data. Significant regional differences in TKI selection and resistance rates were observed: the highest first-line resistance rates were in Cherkasy (40%), Vinnytsia (38.6%), and Zakarpattia (32%) regions, while the lowest was in Zhytomyr (5%). Among second-line agents, nilotinib was most widely used (ranging from 20% to 100% depending on the region), while bosutinib was primarily employed as third-line therapy. Conclusions. CML treatment in Ukraine generally aligns with international standards. However, identified regional differences in TKI selection and resistance rates warrant further individual analysis. Implementation of BCR::ABL1 kinase domain mutation analysis and expanded access to novel TKIs (asciminib, ponatinib) may improve outcomes in patients with resistant CML.
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