Korol Ellen E, Wang Sisi, Johnston Karissa, Ravandi-Kashani Farhad, Levis Mark, van Nooten Floortje
ICON Commercialisation and Outcomes, 450-688 West Hastings Street, Vancouver, BC V6B1P1 Canada.
MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 USA.
Oncol Ther. 2017;5(1):1-16. doi: 10.1007/s40487-016-0039-6. Epub 2017 Jan 27.
Patients with acute myeloid leukemia (AML), especially those with relapsed or refractory AML, have poor clinical prognosis and outcomes. Health-related quality of life (HRQoL) assessments have become increasingly important in oncology, aiding in identifying and informing supportive therapy needs during treatment and beyond; however, HRQoL in hematology, and AML in particular, has received relatively minor attention. The aim was to identify and summarize estimates of HRQoL in patients with AML, including patients with relapsed or refractory AML.
A systematic literature review was performed. MEDLINE and EMBASE databases were searched for peer-reviewed literature published between 2004 and 2014 in the US and Europe. Abstracts from four relevant conference proceedings between 2012 and 2014 were reviewed. Data from eligible studies were extracted describing the HRQoL instruments used, domains assessed, and HRQoL scores reported.
Fourteen peer-reviewed studies met the eligibility criteria and were included in the review. Cancer- or leukemia-specific HRQoL measures were used in 78.6% of the studies. Overall, HRQoL was superior among AML survivors compared to individuals on active treatment. Fatigue was identified as the most problematic symptom domain in patients, irrespective of their treatment status. Reported HRQoL declined shortly after diagnosis or treatment initiation and recovered over time.
The included studies identified a decrease in HRQoL after treatment initiation and highlighted the role of fatigue in HRQoL in this patient population. Limited HRQoL data were identified among relapsed or refractory AML patients although they have worse prognostic outcomes. New treatment options that have less negative impact on HRQoL or health initiatives specifically targeting HRQoL of patients with AML are warranted. In addition, further studies exploring HRQoL in the relapsed or refractory patient population are needed to inform disease management and treatment decisions.
急性髓系白血病（AML）患者，尤其是复发或难治性AML患者，临床预后和结局较差。与健康相关的生活质量（HRQoL）评估在肿瘤学中变得越来越重要，有助于确定并告知治疗期间及之后的支持性治疗需求；然而，血液学领域，尤其是AML患者的HRQoL受到的关注相对较少。本研究旨在确定并总结AML患者，包括复发或难治性AML患者的HRQoL评估结果。
进行了一项系统的文献综述。检索MEDLINE和EMBASE数据库，查找2004年至2014年在美国和欧洲发表的同行评审文献。对2012年至2014年四次相关会议论文集的摘要进行了审查。提取符合条件的研究数据，描述所使用的HRQoL工具、评估领域和报告的HRQoL分数。
14项同行评审研究符合纳入标准并被纳入综述。78.6%的研究使用了癌症或白血病特异性HRQoL测量方法。总体而言，与接受积极治疗的个体相比，AML幸存者的HRQoL更好。无论治疗状态如何，疲劳被确定为患者中最成问题的症状领域。报告的HRQoL在诊断或开始治疗后不久下降，并随时间恢复。
纳入的研究确定了治疗开始后HRQoL的下降，并强调了疲劳在该患者群体HRQoL中的作用。尽管复发或难治性AML患者的预后较差，但在这些患者中发现的HRQoL数据有限。有必要开发对HRQoL负面影响较小的新治疗方案或专门针对AML患者HRQoL的健康倡议。此外，需要进一步研究探索复发或难治性患者群体的HRQoL，以为疾病管理和治疗决策提供依据。
