Abstract / Summary
Abstract: The introduction of tyrosine kinase inhibitors (TKIs) has transformed chronic myeloid leukemia (CML) into a chronic condition. However, contemporary population-level data from Latin America remain scarce. We performed a retrospective, population-based cohort study including adults with incident CML diagnosed between 2018 and 2023 within a Colombian health insurance system covering ∼5.3 million individuals. Patients were identified through International Classification of Diseases 10th Revision codes and confirmed by individual hematology chart review with cytogenetic and/or molecular verification of BCR :: ABL1 . Incidence, prevalence, treatment patterns, treatment switching due to resistance or intolerance, adverse events, and overall survival (OS) were assessed using descriptive analyses and the Kaplan-Meier method. Among 354 confirmed incident cases (median age, 51 years; 54.8% male), 174 of 200 patients (87%) were diagnosed in the chronic phase. Annual incidence ranged from 0.9 to 2.6 per 100 000 affiliates, whereas prevalence increased nearly fivefold from 1.32 to 6.23 per 100 000 between 2018 and 2023. Imatinib remained the predominant first-line TKI (53.1%). Notably, 38% of patients required second-line therapy, primarily because of resistance or intolerance. Adverse events aligned with established safety profiles. Five-year OS was 86.3% (95% confidence interval, 81.4-91.5). In this large real-world cohort from a middle-income Latin American setting, CML demonstrates rising prevalence and survival outcomes comparable to contemporary international benchmarks. Nevertheless, the substantial rate of treatment switching underscores ongoing unmet needs in resistance management and therapeutic optimization in routine clinical practice.