Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.
Department of Hematology, the First Affiliated Hospital of Nanyang Medical College, Nanyang, China.
Ann Palliat Med. 2022 Apr;11(4):1336-1350. doi: 10.21037/apm-22-158.
The main objective of this study was to explore health-related quality of life (HRQoL) profiles, chronic disease management practices and key factors associated with HRQoL in 540 patients with chronic myeloid leukemia in chronic phase (CML-CP) administered tyrosine kinase inhibitors (TKIs).
Adult CML-CP patients treated with TKIs in Henan Cancer Hospital from March 2015 to October 2019 were assessed via questionnaires, including demographic characteristics, TKI medications, participation in CML disease management, and HRQoL, in a cross-sectional investigation. Respondents were anonymous. Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) was used to measure HRQoL. A multivariate linear regression model with stepwise entry was used to investigate variables independently associated with HRQoL domain and total scores.
Totally, 540 respondents were included; 302 (55.93%) were male. Mean participant age was 42.90±13.00 years; 169 (31.3%), 178 (32.9%) and 193 (35.7%) individuals had a low, moderate or high disease management level, respectively. Except for insignificant event-free survival information, participants with higher disease management levels also had significantly higher rates of completing re-examination, drug withdrawal, cytogenetic response (CcyR) and/or major molecular response (MMR) (all P<0.01). Moreover, higher disease management level was accompanied by eight significantly higher HRQoL domains (all P<0.01). In multivariate linear regression analysis, variables significantly associated with a higher HRQoL included: (I) high disease management level (B=3.68, P=0.046); (II) transportation convenience (B=6.67, P<0.001); (III) family annual income >10,000 CNY (B=5.97, P<0.001); (IV) completed re-examination (B=4.58, P=0.036); (V) MMR (B=3.75, P=0.021) and CcyR (B=5.15, P=0.035). Female sex (B=-3.53, P=0.010), single status or divorce (B=-1.89 and -2.94, P=0.005 and 0.011), and low education level (B=-1.44, P=0.019) were significantly associated with lower HRQoL.
Higher disease management level was significantly associated with higher elevated treatment efficacy and HRQoL in Chinese individuals with CML-CP administered TKIs. These data indicate the importance of chronic disease management on people's HRQoL and clinical outcome.
本研究的主要目的是探讨 540 例接受酪氨酸激酶抑制剂（TKI）治疗的慢性髓系白血病慢性期（CML-CP）患者的健康相关生活质量（HRQoL）特征、慢性病管理实践以及与 HRQoL 相关的关键因素。
采用横断面调查方法，对 2015 年 3 月至 2019 年 10 月在河南省肿瘤医院接受 TKI 治疗的成年 CML-CP 患者进行问卷调查，内容包括人口统计学特征、TKI 药物、CML 疾病管理参与情况以及 HRQoL。受访者为匿名。采用功能性评估癌症治疗-白血病量表（FACT-Leu）来衡量 HRQoL。采用逐步进入的多元线性回归模型来探讨与 HRQoL 各领域和总分独立相关的变量。
共纳入 540 名受访者；其中 302 名（55.93%）为男性。参与者的平均年龄为 42.90±13.00 岁；169 名（31.3%）、178 名（32.9%）和 193 名（35.7%）患者的疾病管理水平分别较低、中等和较高。除无事件生存信息不显著外，具有较高疾病管理水平的患者完成复查、停药、细胞遗传学缓解（CcyR）和/或主要分子缓解（MMR）的比例也显著更高（均 P<0.01）。此外，较高的疾病管理水平还伴随着 8 个 HRQoL 领域显著提高（均 P<0.01）。多元线性回归分析显示，与更高 HRQoL 相关的变量包括：（I）较高的疾病管理水平（B=3.68，P=0.046）；（II）交通便利（B=6.67，P<0.001）；（III）家庭年收入>10,000 元人民币（B=5.97，P<0.001）；（IV）完成复查（B=4.58，P=0.036）；（V）MMR（B=3.75，P=0.021）和 CcyR（B=5.15，P=0.035）。女性（B=-3.53，P=0.010）、单身或离异（B=-1.89 和-2.94，P=0.005 和 0.011）和较低的教育水平（B=-1.44，P=0.019）与较低的 HRQoL 显著相关。
较高的疾病管理水平与中国接受 TKI 治疗的 CML-CP 患者更高的治疗效果和 HRQoL 显著相关。这些数据表明慢性病管理对人们的 HRQoL 和临床结局具有重要意义。
