The impact of chronic myeloid leukemia on employment: the French prospective study
Patients with chronic myeloid leukemia treated with breakpoint cluster region-Abelson tyrosine kinase inhibitors are likely to survive in excess of 20 years after diagnosis. New challenges appear as we consider life after the disease, including professional challenges and the social reintegration of patients. The purpose of this study was to determine the impact of chronic myeloid leukemia on employment within 2 years after diagnosis. This prospective, observational study included patients diagnosed with chronic myeloid leukemia and treated with a tyrosine kinase inhibitor. Two populations were defined as patients who reported modifications in their professional activity during the study (Acti-Pro+) and patients who did not report a modification (Acti-Pro−). Cancer survivors received a self-assessment questionnaire. The primary endpoint was to determine the professional status of patients. One hundred patients completed the questionnaire. Sixty-six patients out of 100 reported professional activity within 2 years after their diagnosis. During the 2 years after the diagnosis, 65.2% (95% confidence interval (CI), 53.7–76.7) of patients faced modifications in their professional activity due to chronic myeloid leukemia or adverse effects of drug treatments (group Acti-Pro+); in contrast, 34.8% of patients did not report any impact on their occupational activity (group Acti-Pro−). Among modifications to work organization, a change in the number of working hours was the most represented. Other modifications comprised changes in status or work pace. A majority of chronic myeloid leukemia patients face professional consequences of their disease and treatments. Our findings suggest that adverse drug reactions are a major factor affecting the occurrence of work modifications in this context.
KeywordsCancer Chronic myeloid leukemia Return to work Occupational health practice
SDB, FV, FD, FHu, and FHe created the study concept and design. CP, MG, MS, and FD performed the acquisition of data. SDB, FV, FHu, FD, JMS, ED, GL, and FHe performed the analysis and interpretation of data. SDB, FV, FHu, and FHe wrote the draft of the manuscript. FD, ED, JMS, GL, and FHu undertook critical revision of the manuscript. All authors read and approved the final manuscript.
This work received support from the National Research Agency (Agence Nationale de la Recherche (ANR)) for “investissement d’avenir” (“Investment in the Future”) (ANR-11-PHUC-001; CAPTOR). The financial support was used to perform the data collection. The ANR was not involved in the design of the study, analysis, interpretation of data, or writing the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics approval and consent to participate
All procedures performed in the study that involved human participants were in accordance with the ethical standards of the institutional committee, national research committee, and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
Availability of data and material
The datasets generated and analyzed during the study are available from the corresponding author on reasonable request.
- 1.Estimation nationale de l’incidence des cancers en France entre 1980 et 2012 (2013) Maladies chroniques et traumatismes/Rapports et synthèses/Publications et outils/Accueil [Internet]. Disponible sur: http://invs.santepubliquefrance.fr/Publications-et-outils/Rapports-et-syntheses/Maladies-chroniques-et-traumatismes/2013/Estimation-nationale-de-l-incidence-des-cancers-en-France-entre-1980-et-2012. Accessed 24 Nov 2017
- 2.Repsold L, Pool R, Karodia M, Tintinger G, Joubert AM (2017) An overview of the role of platelets in angiogenesis, apoptosis and autophagy in chronic myeloid leukaemia. Cancer Cell Int 17:89 Disponible sur: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664592/ CrossRefGoogle Scholar
- 3.Personal history and quality of life in chronic myeloid leukemia patients: a cross-sectional... - Abstract - Europe PMC [Internet]. Disponible sur: http://europepmc.org/abstract/med/27260015. Accessed 24 Nov 2017
- 5.Phillips KM, Pinilla-Ibarz J, Sotomayor E, Lee MR, Jim HSL, Small BJ, Sokol L, Lancet J, Tinsley S, Sweet K, Komrokji R, Jacobsen PB (2013) Quality of life outcomes in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors: a controlled comparison. Support Care Cancer 21(4):1097–1103CrossRefGoogle Scholar
- 7.Hamerschlak N, de Souza C, Cornacchioni AL, Pasquini R, Tabak D, Spector N, Steagall M (2014) Quality of life of chronic myeloid leukemia patients in Brazil: ability to work as a key factor. Support Care Cancer 22(8):2113–2118Google Scholar
- 9.Baccarani M, Deininger MW, Rosti G, Hochhaus A, Soverini S, Apperley JF, Cervantes F, Clark RE, Cortes JE, Guilhot F, Hjorth-Hansen H, Hughes TP, Kantarjian HM, Kim DW, Larson RA, Lipton JH, Mahon FX, Martinelli G, Mayer J, Muller MC, Niederwieser D, Pane F, Radich JP, Rousselot P, Saglio G, Saussele S, Schiffer C, Silver R, Simonsson B, Steegmann JL, Goldman JM, Hehlmann R (2013) European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013. Blood 122(6):872–884CrossRefGoogle Scholar
- 10.Common Terminology Criteria for Adverse Events (CTCAE)|Common Terminology Criteria for Adverse Events (CTCAE)|Protocol Development|CTEP [Internet]. Available from: https://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm#ctc_50. Accessed 14 Jun 2018
- 11.Chow SL, Ting AS, Su TT (2014) Development of conceptual framework to understand factors associated with return to work among cancer survivors: a systematic review. Iran J Public Health 43(4):391–405Google Scholar
- 14.Efficace F, Rosti G, Breccia M, Cottone F, Giesinger JM, Stagno F, Iurlo A, Russo Rossi A, Luciano L, Martino B, Galimberti S, Turri D, Bergamaschi M, Tiribelli M, Fava C, Angelucci E, Mandelli F, Baccarani M (2016) The impact of comorbidity on health-related quality of life in elderly patients with chronic myeloid leukemia. Ann Hematol 95(2):211–219CrossRefGoogle Scholar
- 15.Unnikrishnan R, Veeraiah S, Ganesan P (2017) Symptom burden and quality of life issues among patients of chronic myeloid leukemia on long-term imatinib therapy. Indian J Med Paediatr Oncol 38(2):165–168Google Scholar
- 18.Saiki CB, Waldfogel JM, Lee EK, Smith TJ (2017) Strategies for addressing cancer patients’ complaints of fatigue. Oncology (Williston Park, NY) 31(11):808–812Google Scholar
- 19.Efficace F, Baccarani M, Breccia M, Cottone F, Alimena G, Deliliers GL, Baratè C, Specchia G, di Lorenzo R, Luciano L, Turri D, Martino B, Stagno F, Dabusti M, Bergamaschi M, Leoni P, Simula MP, Levato L, Fava C, Veneri D, Sica S, Rambaldi A, Rosti G, Vignetti M, Mandelli F (2013) Chronic fatigue is the most important factor limiting health-related quality of life of chronic myeloid leukemia patients treated with imatinib. Leukemia 27(7):1511–1519CrossRefGoogle Scholar