a Division of Hematology and BMT, Department of Experimental and Clinical Medical Sciences , Azienda Sanitaria Universitaria Integrata di Udine , Udine , Italy.
Expert Rev Hematol. 2017 Jan;10(1):9-14. doi: 10.1080/17474086.2017.1262758. Epub 2016 Nov 30.
Patients reported outcome (PRO) are still under-used in patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs), though data on the correlation between quality of life (QoL) and therapeutic efficacy are increasingly known. Chronic low-grade toxicities can reduce patient's QoL and negatively impact on adherence. Areas covered: This review will focus on the role of QoL questionnaires in patients with CML, receiving imatinib or newer TKIs (dasatinib, nilotinib, bosutinib, ponatinib). Physicians tend to underestimate the impact of TKI-related symptoms, in particular fatigue, that negatively affect QoL and can be a reason of poor adherence to therapy, with detrimental effect on long-term response. Few studies pointed out the role of PRO in CML, and there is paucity of questionnaires specifically designed for CML patients. Expert commentary: We recommend a wider use of PRO to join the pursuit of a rapid and deep responses with an optimization of QoL.
患者报告的结局(PRO)在接受酪氨酸激酶抑制剂(TKI)治疗的慢性髓性白血病(CML)患者中仍未得到充分应用,尽管越来越多的数据表明生活质量(QoL)与治疗效果之间存在相关性。慢性低度毒性会降低患者的 QoL,并对其治疗依从性产生负面影响。
本综述将重点关注接受伊马替尼或新型 TKI(达沙替尼、尼洛替尼、博舒替尼、普纳替尼)治疗的 CML 患者中 QoL 问卷的作用。医生往往低估了 TKI 相关症状的影响,特别是疲劳,这些症状会对 QoL 产生负面影响,并可能导致治疗依从性差,对长期反应产生不利影响。少数研究指出了 PRO 在 CML 中的作用,而且专门为 CML 患者设计的问卷也很少。
我们建议更广泛地使用 PRO,以追求快速和深度的反应,并优化 QoL。