Young age and high cost are associated with future preference for stopping tyrosine kinase inhibitor therapy in Chinese with chronic myeloid leukemia

被引:38
作者
Jiang, Qian [1 ,2 ]
Liu, Zheng-Chen [3 ]
Zhang, Song-Xin [3 ]
Gale, Robert Peter [4 ]
机构
[1] Peking Univ, Peking Univ Peoples Hosp, Inst Hematol, Beijing Key Lab Hematopoiet Stem Cell Transplanta, 11 Xizhimen South St, Beijing 100044, Peoples R China
[2] Soochow Univ, Collaborat Innovat Ctr Hematol, Suzhou, Peoples R China
[3] New Sunshine Char Fdn, Beijing, Peoples R China
[4] Univ London Imperial Coll Sci Technol & Med, Div Expt Med, Dept Med, Haematol Res Ctr, London, England
基金
中国国家自然科学基金;
关键词
Tyrosine kinase inhibitors; Chronic myeloid leukemia; Imatinib; Nilotinib; Dasatinib; COMPLETE MOLECULAR REMISSION; CHRONIC MYELOGENOUS LEUKEMIA; PATIENT PREFERENCES; CHRONIC PHASE; IMATINIB; DISCONTINUATION; OUTCOMES; TRIAL;
D O I
10.1007/s00432-016-2159-7
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
To explore therapy-goals and patients' expectations regarding discontinuing tyrosine kinase inhibitors (TKIs) therapy in Chinese with chronic myeloid leukemia (CML). To identify variables associated with these expectations and preferences. Noninterventional, cross-sectional study using questionnaires distributed to persons with CML and answered anonymously. With CML in chronic phase, 888 respondents were evaluable. In total, 513 respondents (58 %) were male. Median age was 41 years (range 18-88 years). Median TKI therapy duration was 3 years (range < 1-13 years). In total, 735 respondents (83 %) paid part or all of the cost of TKI. As their treatment goal, 430 of 888 respondents (48 %) reported treatment-free remission (TFR). In the future, 734 respondents (83 %) expected to discontinue TKI. Multivariate analyses confirmed younger age [HR = 1.3; (1.1, 1.4); P < 0.001] and higher out-of-pocket expense [HR = 1.2; (1.1, 1.4); P < 0.001] were associated with TFR as a therapy-goal. Both variables were also associated with patients' hope to stop TKI therapy in the future: HR = 1.4; (0.8, 1.7; P < 0.001) and HR = 1.5; (1.3, 1.8; P < 0.001). Achieving a complete molecular response [HR = 1.8 (1.1, 2.9); P = 0.017] and decreased quality of life resulting from adverse effects [HR = 1.2; (1.0, 1.5); P = 0.021] were factors associated with the expectation of discontinuing TKI therapy. Younger age and higher out-of-pocket cost are associated with patients' preference for stopping TKI therapy.
引用
收藏
页码:1539 / 1547
页数:9
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