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Commentaries on the Hammersmith Protocol for Clinical Decisions in CML in the IM Era

Compiled by Anjana

From the Seminars in Hematology, April 2003

8 CML Experts are:

Francois-Xavier Mahon, MD- Laboratoire de Greffe de Moelle, UniversiteVictor Segelen, Bordeaux, France. He is a French CML expert, many publications and presentations.

Michele Baccarani, MD-
University of Bologna, Bologna, Italy.Institute of Hematology and Medical Oncology

Tim Hughes, MD -
Division of Hematology, Institute of Medical and Veterinary Science, Adelaide, Australia.

Francois Guilhot, MD
Department of Oncology-Hematology and Cell Therapy, CHU La Milerie, Poitiers, France.

Brian J. Druker, MD-
Oregon Health and Science University Cancer Institute, Portland, Oregon, USA.

Jorge Cortes, MD -
Dept Of Leukemia, The University of Texas, M.D. Anderson Cancer Center, Houston, Texas, USA.

Andreas Hochhaus, MD -
Klinische Medizin Mannheim der Universita Heidelberg, Mannheim, Germany.

George Q. Daley, MD PhD -
Division of Pediatric
Hematology/Oncology, Children's Hospital and Dana Faber Cancer
Institute, Boston, MA, USA.

Foreword

Please remember that CML experts will differ in their opinions and we must look for general consensus. However, each opinion is a pearl of wisdom, I could not argue with any of them based on my own layman knowledge. This also drives home the fact that we need to be informed patients and take more than one medical opinion in a sticky situation. Patients deserve the best possible care and for this achievement, some degree of patient involvement especially in CML knowledge is necessary since sometimes the experts will leave it to the patient and his family to make an important decision. Patients who are not treated at the top centers but by local oncs may at times need to check that they are being treated by current CML protocols. I have found local oncs in general to be busy but kindly individuals who will read any articles by experts the patient may present and discuss treatment strategies based on that.

When Roy was diagnosed with CML and our first onc was recommending Interferon and we quoted patients who were giving us Gleevec feedback, our first onc shot back, "Who are they and what do they know?" This taught me an important lesson when helping others. An article by a CML expert which has been peer reviewed obviously carries more weight with oncs than word from other patients. 2 patients who were being treated with suboptimal Gleevec doses approached me on the lists. I passed articles by CML experts to them to show to their oncs and immediately their treatment strategies were changed. That is why CML articles have an important place in our lives, especially if we are not treated at the top centers.

After great deliberation whether to present each CML expert's opinions in separate posts, I came to the conclusion that if I sifted through and rearranged the information in categories, it may be more beneficial for the group since expert opinions at one glance on one topic may better aid our understanding.

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