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患者及血液科医生对慢性髓性白血病酪氨酸激酶抑制剂治疗的担忧。

Patients' and hematologists' concerns regarding tyrosine kinase-inhibitor therapy in chronic myeloid leukemia.

作者信息

Jiang Qian, Yu Lu, Gale Robert Peter

机构信息

Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Beijing, China.

Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.

出版信息

J Cancer Res Clin Oncol. 2018 Apr;144(4):735-741. doi: 10.1007/s00432-018-2594-8. Epub 2018 Jan 29.


DOI:10.1007/s00432-018-2594-8
PMID:29380058
Abstract

PURPOSE: To explore patients' and hematologists' concerns regarding tyrosine kinaseinhibitor (TKI)-therapy and identify variables associated these concerns. Methods A cross-sectional questionnaire including 16 common issues related to TKI-therapy was distributed to adults with chronic myeloid leukemia (CML) receiving TKIs and hematologists treating CML patients and answered anonymously. RESULTS: Data from 1518 patient respondents receiving TKI-therapy ≥ 3 months were analyzed. 939 (62%) were male. Median age was 42 years. 72% were receiving imatinib. Median TKI-therapy duration was 27 months. Data from 259 hematologist respondents were analyzable. 154 (59%) treated > 5 persons with CML per month. Median number of concerns was 5 (range 0-16) for both patients and hematologists. The top five issues for both cohorts were new drug development, stopping TKI-therapy, TKI-reimbursement policies, TKI-related adverse effects and long-term efficacy of TKIs. 12 issues attracted proportionally discordant attention between patients and hematologists. Patients were more concerned with TKI-reimbursement policies, price reduction of TKIs, TKI-related adverse effects, restrictions to daily life, CML knowledge and interpretation of laboratory data, whereas hematologists were more concerned with stopping TKI-therapy, TKI choice, monitoring, TKI dose-adjustment, quality of generics and switching between branded and generic TKIs. In multivariate analyses female sex [OR = 1.4 (1.1-1.7); p = 0.008], education level ≥ bachelor e[OR = 1.8 (1.4-2.2); p < 0.001], TKI-therapy duration 36-< 60 months [OR = 1.4 (1.0-1.9); p = 0.049] and having adverse impact on daily life and work [OR = 1.5 (1.2-1.8]; p = 0.001] were associated with greater numbers of patients' concerns. CONCLUSIONS: Our data suggested hematologists need to be aware of CML patients' concerns to improve their quality-of-life and patient-hematologist communication.

摘要

目的:探讨患者和血液科医生对酪氨酸激酶抑制剂(TKI)治疗的担忧,并确定与这些担忧相关的变量。方法 向接受TKI治疗的慢性髓性白血病(CML)成年患者和治疗CML患者的血液科医生发放一份包含16个与TKI治疗相关常见问题的横断面调查问卷,并进行匿名作答。 结果:对1518名接受TKI治疗≥3个月的患者受访者的数据进行了分析。939名(62%)为男性。中位年龄为42岁。72%的患者正在接受伊马替尼治疗。TKI治疗的中位持续时间为27个月。对259名血液科医生受访者的数据进行了分析。154名(59%)医生每月治疗>5名CML患者。患者和血液科医生的担忧中位数均为5(范围0 - 16)。两个队列中最关注的五个问题是新药研发、停止TKI治疗、TKI报销政策、TKI相关不良反应以及TKI的长期疗效。有12个问题在患者和血液科医生之间引起了不成比例的不同关注。患者更关注TKI报销政策、TKI降价、TKI相关不良反应、对日常生活的限制、CML知识以及实验室数据解读,而血液科医生更关注停止TKI治疗、TKI选择、监测、TKI剂量调整、仿制药质量以及品牌TKI与仿制药之间的转换。在多变量分析中,女性[比值比(OR)=1.4(1.1 - 1.7);p = 0.008]、教育水平≥本科[OR = 1.8(1.4 - 2.2);p < 0.001]、TKI治疗持续时间36 - <60个月[OR = 1.4(1.0 - 1.9);p = 0.049]以及对日常生活和工作有不利影响[OR = 1.5(1.2 - 1.8);p = 0.001]与患者更多的担忧相关。 结论:我们的数据表明,血液科医生需要了解CML患者的担忧,以改善他们的生活质量以及患者与血液科医生之间的沟通。

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[4]
[Survey and analysis of the concerns of patients with chronic myeloid leukemia in China in 2021].

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[5]
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[6]
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[7]
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Blood Adv. 2021-9-14

[8]
Economics influences therapy decisions in chronic myeloid leukaemia: should it?

J Cancer Res Clin Oncol. 2021-12

[9]
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Mediterr J Hematol Infect Dis. 2021-1-1

[10]
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本文引用的文献

[1]
Higher out-of-pocket expenses for tyrosine kinase-inhibitor therapy is associated with worse health-related quality-of-life in persons with chronic myeloid leukemia.

J Cancer Res Clin Oncol. 2017-12

[2]
First-line treatment selection and early monitoring patterns in chronic phase-chronic myeloid leukemia in routine clinical practice: SIMPLICITY.

Am J Hematol. 2017-11

[3]
Assessment of imatinib as first-line treatment of chronic myeloid leukemia: 10-year survival results of the randomized CML study IV and impact of non-CML determinants.

Leukemia. 2017-11

[4]
Long-Term Outcomes of Imatinib Treatment for Chronic Myeloid Leukemia.

N Engl J Med. 2017-3-9

[5]
Variables associated with patient-reported outcomes in persons with chronic myeloid leukemia receiving tyrosine kinase-inhibitor therapy.

J Cancer Res Clin Oncol. 2017-6

[6]
Factors Associated With Tyrosine Kinase Inhibitor Initiation and Adherence Among Medicare Beneficiaries With Chronic Myeloid Leukemia.

J Clin Oncol. 2016-12-20

[7]
Differences in treatment goals and perception of symptom burden between patients with myeloproliferative neoplasms (MPNs) and hematologists/oncologists in the United States: Findings from the MPN Landmark survey.

Cancer. 2017-2-1

[8]
Life Expectancy of Patients With Chronic Myeloid Leukemia Approaches the Life Expectancy of the General Population.

J Clin Oncol. 2016-6-20

[9]
Molecular monitoring of tyrosine kinase inhibitor therapy of chronic myeloid leukemia in China.

J Cancer Res Clin Oncol. 2016-7

[10]
Young age and high cost are associated with future preference for stopping tyrosine kinase inhibitor therapy in Chinese with chronic myeloid leukemia.

J Cancer Res Clin Oncol. 2016-7

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