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Impact of Healthcare Settings on Survival Time of Patients With CML Research · March 12, 2014

See home page for link to this article in 'Blood'

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In this analysis of almost 1500 patients with newly diagnosed CML treated with imatinib, investigators noted that when categorizing patients into cohorts based on where treatment was given—teaching hospital, municipal hospital, or in the office of an office-based physician—patients receiving treatment at teaching hospitals had a lower risk of death compared with those treated in the other locations. There are also seemed to be improved survival in the teaching hospital setting after blast crisis.
Although this is a retrospective analysis, the report does raise an important issue in the management of patients with CML.- Chris Tully, MD

Seems quite an interesting result - have they ever done anything like this in the UK?

Karen

Not sure Karen, but I suspect not- however,I think we would all agree that in the case of any serious disease it is crucial that you are treated at a centre that has experienced/expert clinicians or at least by clinicians who are able (and willing) to access specialist expertise as well as good pathology and monitoring services. Of course the first hurdle is to get a correct diagnosis, and often in the case of CML at least, this depends on astute primary care doctors (GP's).

Hope all is well with you and bosutinib?

Sandy

Specialist centres are really the best way if there are any queries but, as you say, it depends on willingness to push patients through to them from the local hospital.
Bosutinib seems to be working (fingers crossed, touch wood etc!) and I have had three pretty good results in a row.
Hope all is well with you
K

I'm not at all surprised by this. Indeed it seems to me to just be confirming what common sense (and personal experience) would tell me is going to be blinding obvious.

It was 20 years ago when I was diagnosed and initially when I was already seriously ill and so unwell I'd been admitted into a District Hospital. Frankly they messed about, were at a loss what to do and nearly totally messed up! But fortunately I got transferred to a specialist unit and never looked back.

Over the years I've occasionally met other people that have CML and who are being treated at other places and quite frankly they've just not had the same opportunity or treatment that I've had.

I got a range of treatment which to be honest would nowadays not ordinarily be done or considered as best practice but at the time it was leading edge and not widely available or considered to be "economically viable" or even good in terms of prognosis and outcome and it wasn't an easy journey.

I'll never forget some 16 years ago and by huge coincidence totally randomly coming across the husband of a lady aged just nearly 40 and the mother of 3 young boys telling me his wife had a leukaemia called Chronic Myeloid Leaukaemia. Now this man didn't know I'd even had leukaemia at all and I am so glad that I never said at the early part of the story because basically he went on to tell me she had been sent home to die because there was no viable treatment and that day had been admitted into a hospice. He went on to tell me that she couldn't have a bone marrow transplant because she was too old and the risks were too high so "they" didn't do them with 'older' people because they just died and "there was this drug called interferon but it was expensive and there was no evidence it worked and it was just pharmaceutical companies making loads of money".

I just didn't know what to say to this poor man, because he was just so upset and I certainly was not going to be talking about my experience. I went on interferon for about a year and that, along with other treatment kept me alive to have a matched unrelated bone marrow transplant at age 44. At the time I was over a year post transplant.

I never joined support groups and the like because I was very well aware that not all treatment is the same and not everyone is getting the best and I always found conversations incredibly difficult.

But I know from personal experience that the best medical science and resources and new methodology and techniques are the thing that gives you the best possible chance at a good outcome.

When faced with a cancer diagnosis you really don't want people "doing there best", working within confines of knowledge, budget, and other resources. You want people who are the best with access to the best.

Then at least you're getting every chance.