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第一代与第二代酪氨酸激酶抑制剂治疗的慢性髓性白血病患者的健康相关生活质量

Health-Related Quality of Life in Patients with Chronic Myeloid Leukemia Treated with First- Versus Second-Generation Tyrosine Kinase Inhibitors.

作者信息

Shacham Abulafia Adi, Shemesh Sivan, Rosenmann Lena, Berger Tamar, Leader Avi, Sharf Giora, Raanani Pia, Rozovski Uri

机构信息

Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah-Tikva 49100, Israel.

Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

出版信息

J Clin Med. 2020 Oct 25;9(11):3417. doi: 10.3390/jcm9113417.

Abstract

The life expectancy of patients with chronic myeloid leukemia (CML) approaches that of the age-matched population and quality of life (QOL) issues are becoming increasingly important. To describe patients' characteristics and assess QOL, we delivered a 30-item core questionnaire, a 24-item CML-specific questionnaire, both from the European Organization for Research and Treatment of Cancer (EORTC), and additional health-related items to 350 patients. Among 193 patients who completed the questionnaires, 139 received either imatinib ( = 70, 33%), dasatinib ( = 45, 23%) or nilotinib ( = 24, 12%). Patients' median age was 58 (range: 23 to 89) years and 86 (63%) were males. Stratifying patients by treatment, we recognized two distinct populations. In comparison to patients on dasatinib and nilotinib, patients on imatinib were two decades older, had a longer duration of disease and current treatment, experienced fewer limitations on daily activities ( = 0.02), less fatigue ( = 0.001), lower degree of impaired body image ( = 0.022) and less painful episodes ( = 0.014). Similarly, they had better emotional functioning, were less worried, stressed, depressed or nervous ( = 0.01) and were more satisfied with their treatment ( = 0.018). Not only does age associate with current treatments, but it also predicts how patients perceive QOL. Young patients express impaired QOL compared with elderly patients.

摘要

慢性髓性白血病(CML)患者的预期寿命接近年龄匹配人群,生活质量(QOL)问题变得越来越重要。为了描述患者特征并评估生活质量,我们向350名患者发放了一份由欧洲癌症研究与治疗组织(EORTC)制定的包含30个条目的核心问卷、一份包含24个条目的CML特异性问卷以及其他与健康相关的条目。在193名完成问卷的患者中,139名接受了伊马替尼(n = 70,33%)、达沙替尼(n = 45,23%)或尼洛替尼(n = 24,12%)治疗。患者的中位年龄为58岁(范围:23至89岁),86名(63%)为男性。按治疗方式对患者进行分层,我们识别出两个不同的群体。与接受达沙替尼和尼洛替尼治疗的患者相比,接受伊马替尼治疗的患者年龄大二十岁,疾病病程和当前治疗时间更长,日常活动受限更少(P = 0.02),疲劳感更少(P = 0.001),身体形象受损程度更低(P = 0.022),疼痛发作次数更少(P = 0.014)。同样,他们的情绪功能更好,焦虑、压力、抑郁或紧张程度更低(P = 0.01),对治疗的满意度更高(P = 0.018)。年龄不仅与当前治疗有关,还能预测患者对生活质量的感知。与老年患者相比,年轻患者的生活质量较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c02/7692789/6714822a8e90/jcm-09-03417-g001.jpg

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