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慢性髓性白血病患者对无需治疗缓解的认知

Patient perceptions of treatment-free remission in chronic myeloid leukemia.

作者信息

Villemagne Sanchez Lucia A, O'Callaghan Clare, Gough Karla, Hall Karen, Kashima Yoshihisa, Seymour John F, Schofield Penelope, Ross David M

机构信息

a Faculty of Medicine, Dentistry, and Health Sciences , University of Melbourne , Melbourne , VIC , Australia.

b Department of Cancer Experience Research , Peter MacCallum Cancer Centre , Melbourne , VIC , Australia.

出版信息

Leuk Lymphoma. 2018 Feb;59(2):406-415. doi: 10.1080/10428194.2017.1337114. Epub 2017 Jun 15.

Abstract

Around half of patients with chronic myeloid leukemia (CML) who achieve a stable deep molecular response would remain in treatment-free remission (TFR) if their tyrosine kinase inhibitors (TKIs) were stopped. TFR is increasingly becoming a goal of treatment. Eighty-seven patients answered a survey exploring patient perceptions of TFR, incorporating CML-specific factors (disease history, treatment toxicity, and adherence) and questions concerning health beliefs. 81% of participants (95% CI: 72%-89%) indicated that they would be willing to attempt TFR. No demographic or CML-related variable in the survey was significantly associated with willingness. In qualitative analysis, the commonest motivations for TFR included TKI toxicity (n = 26) and convenience (n = 18). The leading reason for reluctance was fear of consequences of stopping TKI (n = 16). Reluctance was often associated with needs for additional information or incomplete understanding of the current data. Understanding patient motivations and concerns is important if TFR is to become a part of CML management.

摘要

大约一半达到稳定深度分子反应的慢性髓性白血病(CML)患者,如果停用酪氨酸激酶抑制剂(TKI),将保持无治疗缓解(TFR)状态。TFR日益成为治疗目标。87名患者回答了一项调查,该调查探讨了患者对TFR的看法,纳入了CML特异性因素(疾病史、治疗毒性和依从性)以及有关健康观念的问题。81%的参与者(95%置信区间:72%-89%)表示愿意尝试TFR。调查中的人口统计学或CML相关变量与意愿均无显著关联。在定性分析中,TFR最常见的动机包括TKI毒性(n = 26)和便利性(n = 18)。不愿尝试的主要原因是担心停用TKI的后果(n = 16)。不愿尝试往往与需要更多信息或对当前数据理解不完整有关。如果TFR要成为CML管理的一部分,了解患者的动机和担忧很重要。

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