Young age and high cost are associated with future preference for stopping tyrosine kinase inhibitor therapy in Chinese with chronic myeloid leukemia
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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.
KeywordsTyrosine kinase inhibitors Chronic myeloid leukemia Imatinib Nilotinib Dasatinib
JQ designed the study, collected, analyzed and interpreted the data, and drafted the article. LZC designed the study. ZSX collected the data. RPG interpreted the data and drafted the article. All authors read and approved the final typescript.
This study was funded by National Natural Science Foundation of China (No. 81370637). RPG acknowledges support from the National Institute of Health Research (NIHR) Biomedical Research Centre funding scheme.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Because the survey used anonymous questionnaires, the Ethics Committee of Peoples Hospital determined informed consent of participants was not required.
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