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Meta-Analysis
. 2025 May 3;33(5):446.
doi: 10.1007/s00520-025-09451-4.

Patient-reported toxicity symptoms during tyrosine kinase inhibitor treatment in chronic myeloid leukemia: a systematic review and meta-analysis

Yolba Smit #  1 , Pien Scheuter #  2 , Myrthe P M Lange  2 , Jeroen J W M Janssen  2 , Eduardus F M Posthuma  3 , Charlotte L Bekker  4 , Rosella P M G Hermens  5 , Nicole M A Blijlevens  2
Affiliations
Meta-Analysis

Patient-reported toxicity symptoms during tyrosine kinase inhibitor treatment in chronic myeloid leukemia: a systematic review and meta-analysis

Yolba Smit et al. Support Care Cancer. .

Abstract

Purpose: One in five chronic myeloid leukemia (CML) patients experiences such intolerability that they switch tyrosine kinase inhibitor (TKI) treatment within 3 years. Information on tolerability is needed to guide shared decision-making. However, an overview of symptoms patients experience per TKI is lacking, and physician-graded toxicity underestimates patients' experiences.

Methods: We systematically searched PubMed and Embase from inception to February 2025 and conducted a meta-analysis on the prevalence of patient-reported symptoms in CML per TKI. This study follows the Preferred Reporting Items for Systematic Reviews (PRISMA) guideline for systematic reviews.

Results: We included 11 studies with 2987 patients, reporting on 47 different symptoms of any severity. The low-grade patient-reported symptom burden was high. No data were available on asciminib and ponatinib, and minimal data were available for bosutinib. In indirect, unadjusted comparisons, 13 out of 47 symptoms (of any severity) showed significant differences in prevalence between common TKI types.

Conclusion: Our findings provide essential information to guide treatment decisions in cases of intolerability. However, there is a clear need for further research with standardized instruments, especially in second and third generation TKI types, including direct comparisons and comparisons adjusted for covariates.

Keywords: CML; Chronic myeloid leukemia; Meta-analysis; PROM; Patient-reported outcome measure; TKI; Toxicity; Tyrosine kinase inhibitor.

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Conflict of interest statement

Declarations. Disclaimer: Funding bodies had no role in the design of the study, collection and analysis of data, or the decision to publish. Competing interests: Authors declare the following potential conflicts of interest: CB, no conflicts of interest. EP: research support: AbbVie, AstraZeneca and Janssen. JJ: research support from Abbvie, AstraZeneca, Janssen, Novartis, and BMS; honoraria from Pfizer, Novartis, Incyte, and Abbvie; and is the founder of Apps for Care and Science Foundation and developer of the HematologyApp. The Apps for Care and Science Foundation non-profit organization is supported by Abbvie, AstraZeneca, Amgen, Sanofi-Genzyme, Takeda, Jazz, Roche, Servier, BMS/Celgene, Daiichi-Sankyo, Janssen, and Incyte. ML, no conflicts of interest. NB, no conflicts of interest. RH, research support: AbbVie, AstraZeneca and Janssen. PS, no conflicts of interest. YS, research support: AbbVie, AstraZeneca and Janssen.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of study selection
See this image and copyright information in PMC

References

    1. Abulafia AS, Shemesh S, Rosenmann L, Berger T, Leader A, Sharf G, Raanani P, Rozovski U (2020) Health-related quality of life in patients with chronic myeloid leukemia treated with first-versus second-generation tyrosine kinase inhibitors Journal of. Clin Med 9(11):1–9 - PMC - PubMed
    1. Adattini JA, Gross AS, Wong Doo N, McLachlan AJ (2022) Real-world efficacy and safety outcomes of imatinib treatment in patients with chronic myeloid leukemia: an Australian experience. Pharmacol Res Perspect 10:e01005 - PMC - PubMed
    1. Ali H, Mohamed Z, Abdullah D (2024) Health-related quality of life in chronic myeloid leukaemia patients receiving long-term therapy with different tyrosine kinase inhibitors in Kurdistan region Georgian Med News: 173–180 - PubMed
    1. Atallah E, Schiffer CA, Radich JP, Weinfurt KP, Zhang MJ, Pinilla-Ibarz J, Kota V, Larson RA, Moore JO, Mauro MJ, Deininger MWN, Thompson JE, Oehler VG, Wadleigh M, Shah NP, Ritchie EK, Silver RT, Cortes J, Lin L, Visotcky A, Baim A, Harrell J, Helton B, Horowitz M, Flynn KE (2021) Assessment of outcomes after stopping tyrosine kinase inhibitors among patients with chronic myeloid leukemia: a nonrandomized clinical trial JAMA. Oncol 7:42–50 - PMC - PubMed
    1. Aziz Z, Iqbal J, Aaqib M, Akram M, Saeed A (2011) Assessment of quality of life with imatinib mesylate as first-line treatment in chronic phase-chronic myeloid leukemia. Leuk Lymphoma 52:1017–1023 - PubMed

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