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酪氨酸激酶抑制剂停药后慢性髓性白血病患者的健康相关生活质量和症状:来自 EURO-SKI 试验的结果。

Health-related quality of life and symptoms of chronic myeloid leukemia patients after discontinuation of tyrosine kinase inhibitors: results from the EURO-SKI Trial.

机构信息

Data Center and Health Outcomes Research Unit, Italian Group for Adult Haematologic Diseases (GIMEMA), Rome, Italy.

Bergonié Cancer Institute, INSERM UMR1312 Inserm, University of Bordeaux, Bordeaux, France.

出版信息

Leukemia. 2024 Aug;38(8):1722-1730. doi: 10.1038/s41375-024-02341-4. Epub 2024 Jul 10.

DOI:
10.1038/s41375-024-02341-4
PMID:38987274
Abstract

Limited data is available on the health-related quality of life (HRQoL) and symptoms of patients with chronic myeloid leukemia (CML) who are in treatment-free remission (TFR). We herein report HRQoL results from the EURO-SKI trial. Patients who had been on tyrosine kinase inhibitors (TKIs) therapy for at least 3 years and achieved MR4 for at least 1 year were enrolled from 11 European countries, and the EORTC QLQ-C30 and the FACIT-Fatigue questionnaires were used to assess HRQoL and fatigue respectively. Patients were categorized into the following age groups: 18-39, 40-59, 60-69 and ≥70 years. Of 728 patients evaluated at baseline, 686 (94%) completed HRQoL assessments. The median age at TKI discontinuation was 60 years. Our findings indicate that HRQoL and symptom trajectories may vary depending on specific age groups, with younger patients benefiting the most. Improvements in patients aged 60 years or older were marginal across several HRQoL and symptom domains. At the time of considering TKI discontinuation, physicians could inform younger patients that they may expect valuable HRQoL benefits. Considering the marginal improvements observed in patients aged 60 years or above, it may be important to further investigate the value of TFR compared to a lowest effective dose approach in this older group of patients.

摘要

关于处于无治疗缓解(TFR)的慢性髓性白血病(CML)患者的健康相关生活质量(HRQoL)和症状,相关数据有限。我们在此报告来自 EURO-SKI 试验的 HRQoL 结果。来自 11 个欧洲国家的患者在接受酪氨酸激酶抑制剂(TKI)治疗至少 3 年后,且达到至少 1 年的 MR4,被纳入该试验,并分别使用 EORTC QLQ-C30 和 FACIT-Fatigue 问卷评估 HRQoL 和疲劳。患者被分为以下年龄组:18-39 岁、40-59 岁、60-69 岁和≥70 岁。在基线评估的 728 名患者中,686 名(94%)完成了 HRQoL 评估。TKI 停药时的中位年龄为 60 岁。我们的研究结果表明,HRQoL 和症状轨迹可能因特定年龄组而异,年轻患者受益最大。在几个 HRQoL 和症状领域,60 岁及以上患者的改善幅度较小。在考虑 TKI 停药时,医生可以告知年轻患者,他们可能期望获得有价值的 HRQoL 获益。考虑到 60 岁及以上患者的改善幅度较小,在该老年患者群体中,进一步研究 TFR 与最低有效剂量方法的价值可能很重要。

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