Patient with chronic myeloid leukemia – challenge for primary care physician

Prognosis and overall survival of patients with chronic myeloid leukemia (CML) have improved considerably in recent years due to the introduction of tyrosine kinase inhibitors (TKI), oral medicines inhibiting the mutant forms of BCRABL, and improved results of allogeneic stem cell transplantations. The necessity of long-term drug therapy is connected with a possibility of adverse effects and drug interactions each family doctor should be aware of. The tyrosine kinase inhibitors, alike numerous drugs used in basic health care, are metabolized by cytochrome P450 enzymes and influence the cellular transport proteins. Consequently, this leads to drug interactions that affect both leukemia and its concomitant diseases’ treatment results. Due to health prevention and education, rapid identification and treatment of side effects, the primary care physician can greatly influence better compliance with oncologic recommendations and effectiveness of leukemia therapy. Furthermore,

equally important is developing cooperation between the hematologist and the primary care physician. Current treatment recommendations for CML, as well as TKI characteristic with respect to side effects and drug interactions, are discussed in the paper. The important purpose of this paper is to provoke a discussion within medical community on the importance of the primary care physician in chronic myeloid leukemia treatment or other malignancies.