Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
J Natl Cancer Inst. 2022 Jan 11;114(1):160-164. doi: 10.1093/jnci/djab184.
Treatment-free remission (TFR) is a goal for patients with chronic myeloid leukemia (CML). Functional outcomes after discontinuing tyrosine kinase inhibitor (TKI) treatment have not been described. Patient-Reported Outcomes Measurement Information System (PROMIS) measures of social, physical, cognitive, and sexual function were assessed over 36 months in 172 adult patients with chronic phase CML from 14 sites at baseline (on TKI) and after discontinuation. Linear mixed-effects models described the average trajectories for each patient-reported outcome measure after discontinuation and in those who restarted TKI. Of 112 patients in TFR at 12 months, 103 (92.0%) had a 3-point or greater improvement in social function, 80 (71.4%) in social isolation, 11 (9.8%) in satisfaction with sex life, 4 (3.6%) in physical function, and no patients had a 3-point or greater improvement in cognitive function or interest in sexual activity. Patients' scores worsened after restarting TKI. This novel information on functional outcomes in TFR can help guide patient and clinician decision making.
无治疗缓解 (TFR) 是慢性髓性白血病 (CML) 患者的治疗目标。尚未描述停止酪氨酸激酶抑制剂 (TKI) 治疗后的功能结果。在基线(接受 TKI 治疗时)和停药后 36 个月,来自 14 个地点的 172 名慢性期 CML 成年患者使用患者报告结局测量信息系统 (PROMIS) 评估了社会、身体、认知和性功能方面的情况。线性混合效应模型描述了每个患者报告的结局测量在停药后的平均轨迹,以及那些重新开始 TKI 治疗的患者。在 12 个月时达到 TFR 的 112 名患者中,103 名(92.0%)的社会功能有 3 分或更高的改善,80 名(71.4%)的社会孤立感有 3 分或更高的改善,11 名(9.8%)的性生活满意度有 3 分或更高的改善,4 名(3.6%)的身体功能有 3 分或更高的改善,没有患者的认知功能或性活动兴趣有 3 分或更高的改善。患者在重新开始 TKI 治疗后评分恶化。关于 TFR 中功能结果的这些新信息可以帮助指导患者和临床医生的决策。