Variables associated with patient-reported outcomes in persons with chronic myeloid leukemia receiving tyrosine kinase-inhibitor therapy.

Abstract

Explore patient-reported outcomes (PROs), including health-related quality of life (HRQoL), satisfaction with therapy, impact of the therapy on work and daily life, and concerns related to the therapy and identify variables associated with PROs in persons with chronic myeloid leukemia (CML) receiving tyrosine kinase inhibitors (TKIs). Across-sectional questionnaire was distributed to adults with chronic phase CML and answered anonymously. SF-36 Health Survey was used to measure HRQoL. Our focus was on the physical component summary (PCS) and mental component summary (MCS) components. Data from 819 respondents receiving TKI-therapy ≥3 months and achieving a complete cytogenetic response were analyzed. Median age was 42 years (range 18-88 years). 652 (80%) were receiving imatinib. Median TKI-therapy duration was 36 months (range 3-178 months). 629 (77%) paid some or all of their TKI costs. In multivariate analyses, female sex, increasing age, lower education level, increasing co-morbidities, concomitant medication, ≥3 symptoms, moderate or severe symptom, switch from imatinib to a second-generation TKI, and higher annual out-of-pocket expense of TKI were significantly associated with lower PCS and/or MCS. However, TKI-therapy duration 3-7 years was significantly associated with better well-being. Higher PCS or MCS score was significantly associated with higher satisfaction level with TKI-therapy and lessimpact of TKI-therapy on subject's daily life and work.In addition, adverse impact on daily life and work was significantly associated with more interests in TKI-therapy-related issues. Social-economic and clinical variables were significantly associated with PROs in persons with CML receiving TKI-therapy.