Department of Clinical Pharmacology and Pharmacy, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Eur J Clin Pharmacol. 2019 Jun;75(6):825-829. doi: 10.1007/s00228-019-02640-1. Epub 2019 Feb 7.
To obtain insight into the feasibility of, and the patients' perspective on, dried blood spot (DBS) self-sampling by patients with chronic myeloid leukemia (CML) using nilotinib.
Sixty-eight patients with CML using nilotinib participated in this multicenter observational study. Patients were asked to perform blood sampling by means of the DBS method at home just before drug intake (trough level) and to complete a questionnaire including demographics and five questions on their experience with DBS self-sampling.
Sixty-one patients (57.5 ± 15.0 years, 49% female) provided 178 DBS samples of which 137 (77%) proved useful in clinical practice. Twenty percent of the samples were rejected because the spot size was too small for analysis. A further 3% were taken at the wrong time. Unsuitable DBS samples were provided by 23 patients. Their educational level was significantly lower than that of patients whose samples were all suitable (p = 0.041). Patients considered DBS self-sampling easy and not painful, and three quarters of the patients performed DBS sampling without additional assistance. Patients' belief in the reliability of DBS self-sampling was moderate to high. It was preferred over venous sampling by 37% of the patients, whereas 39% had no preference.
DBS self-sampling by CML patients is feasible in clinical practice provided that patients, particularly those with a lower educational level, are adequately instructed about sample collection with emphasis on timing and volume of sample collection.
了解慢性髓性白血病（CML）患者使用尼洛替尼时，通过干血斑（DBS）自我采样的可行性及其患者观点。
68 例使用尼洛替尼的 CML 患者参与了这项多中心观察性研究。患者被要求在家中通过 DBS 法在服药前（谷浓度）进行采血，并完成一份包括人口统计学和五个关于 DBS 自我采样经验问题的问卷。
61 例患者（57.5±15.0 岁，49%为女性）提供了 178 份 DBS 样本，其中 137 份（77%）在临床实践中有用。20%的样本因斑点太小而无法进行分析而被拒绝。另有 3%的样本采集时间不正确。23 例患者提供了不合适的 DBS 样本。他们的受教育程度明显低于所有样本都合适的患者（p=0.041）。患者认为 DBS 自我采样简单且不痛苦，四分之三的患者在没有额外帮助的情况下进行 DBS 采样。患者对 DBS 自我采样的可靠性持中等至高度信任态度。37%的患者更愿意选择 DBS 采样，而 39%的患者则没有偏好。
只要患者，特别是那些受教育程度较低的患者，经过充分的采样指导，重点强调采样时间和样本量，那么 CML 患者通过 DBS 自我采样在临床实践中是可行的。
