National Clinical Research Center for Hematologic Disease, Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Beijing, 100044, China.
Centre for Haematology Research, Department of Immunology and Inflammation, Imperial College London, London, UK.
J Cancer Res Clin Oncol. 2022 Feb;148(2):449-459. doi: 10.1007/s00432-021-03624-4. Epub 2021 Apr 9.
Define the impact of socio-demographic co-variates on outcomes of persons with newly-diagnosed chronic phase chronic myeloid leukaemia (CML).
Data of 961 consecutive subjects with newly-diagnosed CML were integrated for these outcomes in multi-variable Cox regression analyses after adjusting for confounders and interactions.
Elder age was associated with less use of a 2nd generation TKI as initial therapy. Household registration, comorbidity(ies) and education level were associated with use of a generic rather than branded TKI as initial therapy. Subjects with lower education level were more likely to be diagnosed with CML because of leukaemia-related symptoms. Rural registration and lower education level were also associated with a greater likelihood of switching TKI-therapy. Lower education level was associated with lower likelihood of achieving MMR [HR = 0.8 (0.7, 0.9), p = 0.002], MR [HR = 0.8 (0.7, 1.0), p = 0.055], and poor FFS [HR = 1.7 (1.3, 2.5); p < 0.001], PFS [HR = 2.0 (1.1, 5.0); p = 0.014], CML-related survival [HR = 2.5 (1.0, 10.0); p = 0.060] and survival [HR = 2.5 (1.0, 10.0); p = 0.043]. Males had lower rates of MMR and MR and worse FFS, but not survival compared with females. Being married was associated with a higher rate of MR, fewer failures, progressions, and deaths.
Socio-demographic co-variates have a strong impact on therapy choice and responses in persons with newly-diagnosed CML, including circumstances of diagnosis, risk category and prognosis, use of initial TKI, switching TKIs, response to TKI-therapy, and outcomes.
定义社会人口统计学协变量对新诊断的慢性期慢性髓系白血病（CML）患者结局的影响。
对 961 例新诊断为 CML 的连续患者的数据进行整合，在多变量 Cox 回归分析中调整混杂因素和相互作用后，评估这些结局。
年龄较大与作为初始治疗的第二代 TKI 的使用率较低有关。户籍、合并症和教育水平与初始治疗使用仿制药而非品牌 TKI 有关。教育水平较低的患者因白血病相关症状而更有可能被诊断为 CML。农村户籍和较低的教育水平也与更有可能转换 TKI 治疗有关。较低的教育水平与较低的 MMR 缓解率[HR=0.8（0.7，0.9），p=0.002]、MR 缓解率[HR=0.8（0.7，1.0），p=0.055]、较差的无失败生存[HR=1.7（1.3，2.5）；p<0.001]、PFS 无进展生存[HR=2.0（1.1，5.0）；p=0.014]、CML 相关生存[HR=2.5（1.0，10.0）；p=0.060]和生存[HR=2.5（1.0，10.0）；p=0.043]有关。与女性相比，男性的 MMR 和 MR 缓解率较低，无失败生存率较差，但生存情况无差异。已婚与较高的 MR 缓解率、较少的失败、进展和死亡有关。
社会人口统计学协变量对新诊断的 CML 患者的治疗选择和反应有很大影响，包括诊断情况、风险类别和预后、初始 TKI 的使用、TKI 的转换、TKI 治疗的反应和结局。
