Jiang Qian, Wang Haibo, Yu Lu, Gale Robert Peter
Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Beijing, 100044, People's Republic of China.
Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China.
J Cancer Res Clin Oncol. 2017 Dec;143(12):2619-2630. doi: 10.1007/s00432-017-2517-0. Epub 2017 Sep 11.
To explore health-related quality-of-life (HRQoL) profiles and identify socio-demographic and clinical variables associated with HRQoL in persons with chronic myeloid leukemia (CML) receiving tyrosine kinase inhibitors (TKIs).
A cross-sectional questionnaire was distributed to adults with chronic-phase CML receiving tyrosine kinase-inhibitor (TKI) therapy >3 months in complete cytogenetic response (CCyR). Respondents were anonymous. SF-36 Health Survey was used to measure HRQoL.
Data from 828 respondents were analyzable. 524 (63%) were male. Median age was 42 years (range 18-88 years). 648 (78%) were receiving imatinib. Median TKI-therapy duration was 36 months (range 3-178 months). 638 (77%) paid some or all of their TKI costs. Annual out-of-pocket expenses >$4600 USD was associated with lower physical component summary (PCS; -2.8 to -3.8; P = 0.0081 and 0.0009) and mental component summary (MCS; -2.1 to -4.3; P = 0.0394 and 0.0080) in multivariate analyses. Other variables significantly associated with a lower PCS and/or MCS included: (1) female sex; (2) increasing age; (3) education level < bachelor degree; (4) co-morbidity(ies); and (5) generic drug use. TKI-therapy duration 3-5 years was associated with higher PCS and MCS.
Higher out-of-pocket expense for TKI therapy is significantly associated with worse HRQoL in persons with chronic-phase CML in CCyR receiving TKI therapy. These data indicate the importance of drug cost and health insurance policies on people's HRQoL.
探讨接受酪氨酸激酶抑制剂（TKIs）治疗的慢性髓性白血病（CML）患者的健康相关生活质量（HRQoL）概况，并确定与HRQoL相关的社会人口统计学和临床变量。
向处于慢性期CML且接受酪氨酸激酶抑制剂（TKI）治疗超过3个月且完全细胞遗传学缓解（CCyR）的成年人发放横断面调查问卷。受访者匿名。采用SF-36健康调查来测量HRQoL。
828名受访者的数据可进行分析。524名（63%）为男性。中位年龄为42岁（范围18 - 88岁）。648名（78%）正在接受伊马替尼治疗。TKI治疗的中位持续时间为36个月（范围3 - 178个月）。638名（77%）支付了部分或全部TKI费用。在多变量分析中，年度自付费用>4600美元与较低的身体成分总结得分（PCS；-2.8至-3.8；P = 0.0081和0.0009）和精神成分总结得分（MCS；-2.1至-4.3；P = 0.0394和0.0080）相关。其他与较低PCS和/或MCS显著相关的变量包括：（1）女性；（2）年龄增长；（3）教育水平<本科学历；（4）合并症；（5）使用仿制药。TKI治疗持续3 - 5年与较高的PCS和MCS相关。
对于处于CCyR且接受TKI治疗的慢性期CML患者，TKI治疗的较高自付费用与较差的HRQoL显著相关。这些数据表明药物成本和健康保险政策对人们HRQoL的重要性。
