Clinical Pharmacology Department, Toulouse University Hospital, Toulouse, France.
Inserm Unit 1027, University of Toulouse 3, Toulouse, France.
Support Care Cancer. 2022 Jun;30(6):5431-5440. doi: 10.1007/s00520-022-06968-w. Epub 2022 Mar 18.
The advent of chronic myeloid leukaemia (CML) tyrosine-kinase inhibitors (TKI) has led to new paradigms including occupational rehabilitation.
This study aimed to characterize the impact of CML treatment on sick leaves within the 2 years following diagnosis in working-age patients.
A cohort of all 18-60-year-old newly diagnosed CML patients initiating a TKI between January 1 2011 and December 31 2014 in France was identified in the French National Healthcare database (Système National des Données de Santé [SNDS]). Patients with a sick leave identified in the 24 months after TKI initiation were compared with sex and initiation date matched controls in a nested case-control design. Factors associated with sick leaves were identified through a conditional logistic regression model, providing adjusted odds-ratio (OR) with their 95% confidence interval (CI).
Among 646 18-60-year-old patients, 268 were prescribed at least one sick leave in the study period, with 176 (27.2%) having their first sick leave prescribed after TKI initiation. The median number of sick days over the 2-years period was 115 per patient (interquartile range 25.5-384.5). In the nested case-control study (176 cases and 176 matched controls), sick leaves were more likely observed with second generation TKI (OR 4.11 [1.80-9.38]), whereas they were less likely observed in case if social deprivation (OR 0.07 [0.02-0.28].
More than 25% of working-age CML patients had at least one sick leave within 2 years of TKI initiation, with a higher impact of second generation TKI, and with a median duration of 115 days.
慢性髓性白血病（CML）酪氨酸激酶抑制剂（TKI）的出现带来了新的治疗模式，包括职业康复。
本研究旨在描述 CML 患者诊断后 2 年内接受 TKI 治疗对病假的影响。
在法国国家医疗保健数据库（Système National des Données de Santé [SNDS]）中，我们确定了所有在 2011 年 1 月 1 日至 2014 年 12 月 31 日期间接受 TKI 治疗的 18-60 岁新诊断 CML 患者队列。在 TKI 起始后 24 个月内，通过嵌套病例对照设计，将 TKI 起始后被诊断为患病并请病假的患者与性别和起始日期匹配的对照进行比较。通过条件逻辑回归模型确定与病假相关的因素，并提供调整后的比值比（OR）及其 95%置信区间（CI）。
在 646 名 18-60 岁的患者中，有 268 名患者在研究期间请过至少一次病假，其中 176 名（27.2%）在 TKI 起始后首次请病假。在 2 年期间，每位患者的平均病假天数为 115 天（四分位间距 25.5-384.5）。在嵌套病例对照研究（176 例病例和 176 例匹配对照）中，第二代 TKI 的病假发生率更高（OR 4.11 [1.80-9.38]），而社会贫困的病假发生率较低（OR 0.07 [0.02-0.28]）。
在 TKI 起始后 2 年内，超过 25%的年轻 CML 患者至少请过一次病假，第二代 TKI 的影响更大，平均病假天数为 115 天。
