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. 2020 Oct 25;9(11):3417.
doi: 10.3390/jcm9113417.

Health-Related Quality of Life in Patients with Chronic Myeloid Leukemia Treated with First- Versus Second-Generation Tyrosine Kinase Inhibitors

Adi Shacham Abulafia  1   2 , Sivan Shemesh  2 , Lena Rosenmann  1 , Tamar Berger  1   2 , Avi Leader  1   2 , Giora Sharf  3 , Pia Raanani  1   2 , Uri Rozovski  1   2
Affiliations

Health-Related Quality of Life in Patients with Chronic Myeloid Leukemia Treated with First- Versus Second-Generation Tyrosine Kinase Inhibitors

Adi Shacham Abulafia et al. J Clin Med. .

Abstract

The life expectancy of patients with chronic myeloid leukemia (CML) approaches that of the age-matched population and quality of life (QOL) issues are becoming increasingly important. To describe patients' characteristics and assess QOL, we delivered a 30-item core questionnaire, a 24-item CML-specific questionnaire, both from the European Organization for Research and Treatment of Cancer (EORTC), and additional health-related items to 350 patients. Among 193 patients who completed the questionnaires, 139 received either imatinib (n = 70, 33%), dasatinib (n = 45, 23%) or nilotinib (n = 24, 12%). Patients' median age was 58 (range: 23 to 89) years and 86 (63%) were males. Stratifying patients by treatment, we recognized two distinct populations. In comparison to patients on dasatinib and nilotinib, patients on imatinib were two decades older, had a longer duration of disease and current treatment, experienced fewer limitations on daily activities (p = 0.02), less fatigue (p = 0.001), lower degree of impaired body image (p = 0.022) and less painful episodes (p = 0.014). Similarly, they had better emotional functioning, were less worried, stressed, depressed or nervous (p = 0.01) and were more satisfied with their treatment (p = 0.018). Not only does age associate with current treatments, but it also predicts how patients perceive QOL. Young patients express impaired QOL compared with elderly patients.

Keywords: chronic myeloid leukemia; patient-reported outcome; quality of life; tyrosine kinase inhibitors.

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Conflict of interest statement

Adi Shacham Abulafia—participated in advisory boards of Novartis, Pfizer and BMS. Pia Raanani—participated in advisory boards of Novartis, Pfizer, BMS and Incyte. Giora Sharf—participated in advisory boards of Novartis, Pfizer, BMS, Medisson, Takeda and Incyte. Uri Rozovski, Avi Leader, Sivan Shemesh, Tamar Bergerand Lena Rosenmann declare no conflict of interest.

Figures

Figure 1
Figure 1
Symptom Burden on imatinib vs. dasatinib and nilotinib. Symptom burden according to EORTC QLQ-C30 and EORTC QLQ-CML24 in patients on imatinib, dasatinib or nilotinib. (a) A polar plot summarizes scores of 10 symptom-related items/scales. Higher scores represent worse symptomatology. As shown, patients on imatinib are represented in the inner circle, indicating less symptoms. (b) A bar graph showing that patients on imatinib report less fatigue and pain and a better body image. European Organization for Research and Treatment of Cancer Quality of Life Core Questioner 30 (EORTC QLQ-C30); European Organization for Research and Treatment of Cancer Quality of Life Questioner of Chronic myeloid Leukemia 24 (EORTC QLQ-CML24).
Figure 2
Figure 2
Functional Status on imatinib vs. dasatinib and nilotinib. Functional status according to QLQ30 and CML-24 in patients on imatinib, dasatinib or nilotinib. (a) A polar plot summarizes scores of 5 different aspects of function according to patient reports. Social function is represented in 2 scales (QLQ30 and CML-24). As shown, patients on imatinib are represented in the outer circle, indicating better function. (b) A bar graph showing that patients on imatinib report higher levels of emotional functioning. European Organization for Research and Treatment of Cancer Quality of Life Core Questioner 30 (EORTC QLQ-C30); European Organization for Research and Treatment of Cancer Quality of Life Questioner of Chronic myeloid Leukemia 24 (EORTC QLQ-CML24).
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