Yu L, Jiang Q
Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
Zhonghua Xue Ye Xue Za Zhi. 2018 Jul 14;39(7):533-539. doi: 10.3760/cma.j.issn.0253-2727.2018.07.002.
To explore the comorbidity profile and its impact on reported outcome of patients with chronic myeloid leukemia in chronic phase (CML-CP) receiving tyrosine kinase-inhibitor (TKI) therapy in China. From September 2015 to March 2016, anonymous questionnaires were distributed to adult CML patients who were receiving TKI treatment in China. The questionnaires included demographics, comorbidity(ies), TKI(s) therapy, annual out-of-pocket expense for TKIs, treatment responses, health-related quality of life (HRQoL) measured by the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), satisfaction with therapy, impact of TKI therapy on work and daily life. Data from 1 108 respondents in CML-CP were analyzed, 701 (63.6%) were male, median age was 42 years (range, 18-88 years), 76.4% were currently on imatinib, median TKI-therapy-duration was 29 months (range, 3-178 months). Of them, 300 (27.1%) had ≥1 comorbidity(ies), including hypertension(30.3%), diabetes (21.0%), coronary heart disease (12.3%), gastro-intestinal disease (12.3%), liver disease (11.7%), kidney disease (8.3%), cerebrovascular disease (6.7%) and lung diseases (5.7%), thrombosis (1.3%), other benign diseases (15.3%) and other cancer (8.0%), and 74 (24.7%) had ≥2 comorbidities. Multivariate analyses showed the comorbidity profile of other benign diseases was significantly associated with lower HRQoL score and TKI therapy affecting work and daily life, but it did not significantly affect patients' satisfaction with TKI treatment. Female and no complete cytogenetic response (CCyR) were associated with lower HRQoL score, education level ≥bachelor degree and TKI-therapy duration ≥3 years were associated with higher HRQoL score. Switching between first and second generation TKIs and no CCyR were associated with dis-satisfaction or extreme dis-satisfaction with TKI therapy, free out-of-pocket expense for TKI was associated with better satisfaction. Age<60 years and no CCyR were associated with TKI therapy affecting work and daily life. The survey showed that 27.1% Chinese adult patients with CML-CP receiving TKI-therapy had comorbidity(ies). Different comorbidity profile had different impact on patients' HRQoL and different impact of TKI therapy on work and daily life.
探索中国慢性期慢性髓性白血病(CML-CP)患者接受酪氨酸激酶抑制剂(TKI)治疗时的合并症情况及其对报告结局的影响。2015年9月至2016年3月,向在中国接受TKI治疗的成年CML患者发放了匿名调查问卷。问卷内容包括人口统计学信息、合并症、TKI治疗、TKI的年度自付费用、治疗反应、通过医学结局研究简明健康调查36项量表(SF-36)测量的健康相关生活质量(HRQoL)、对治疗的满意度、TKI治疗对工作和日常生活的影响。分析了1108例CML-CP患者的回复数据,其中701例(63.6%)为男性,中位年龄为42岁(范围18-88岁),76.4%的患者目前正在服用伊马替尼,中位TKI治疗时长为29个月(范围3-178个月)。其中,300例(27.1%)有≥1种合并症,包括高血压(30.3%)、糖尿病(21.0%)、冠心病(12.3%)、胃肠道疾病(12.3%)、肝脏疾病(11.7%)、肾脏疾病(8.3%)、脑血管疾病(6.7%)、肺部疾病(5.