Living, not just surviving, with chronic myeloid leukemia – quality of life to the front of the line

Chronic myeloid leukemia (CML) therapy has come a long way over the last three decades [1]. From a disease where curative options were available to a small percentage of the newly diagnosed patients and even then, with the possibility of significant treatment-related problems, survival is now close to that of age-matched controls in the general population if diagnosed in the chronic phase, patient compliance is good, and the drug is available [2]. Yes, we can debate improvements of a few percent being worth using very new and much more expensive drugs that are not available to much of the world, but we now have a disease where the disease-free-survival is better than overall survival, indicating that people are dying not unexpectedly, but not usually not from CML!

Major improvements in the management of CML, both in terms of drugs available and without a doubt, our ability to monitor disease response or loss of response with molecular technology, are now routinely available and have made this easier on both the patient and the treating physician [3]. One would think that this along with the survival improvement, would be the issue that would give patients the most content. Recent patient-directed surveys have indicated that this may not be true and that what we as physicians consider to be the most important, are often not the same for patients.