Patients’ and hematologists’ concerns regarding tyrosine kinase-inhibitor therapy in chronic myeloid leukemia

  • Qian JiangEmail author
  • Lu Yu
  • Robert Peter Gale
Original Article – Clinical Oncology



To explore patients’ and hematologists’ concerns regarding tyrosine kinaseinhibitor (TKI)-therapy and identify variables associated these concerns. Methods A cross-sectional questionnaire including 16 common issues related to TKI-therapy was distributed to adults with chronic myeloid leukemia (CML) receiving TKIs and hematologists treating CML patients and answered anonymously.


Data from 1518 patient respondents receiving TKI-therapy ≥ 3 months were analyzed. 939 (62%) were male. Median age was 42 years. 72% were receiving imatinib. Median TKI-therapy duration was 27 months. Data from 259 hematologist respondents were analyzable. 154 (59%) treated > 5 persons with CML per month. Median number of concerns was 5 (range 0–16) for both patients and hematologists. The top five issues for both cohorts were new drug development, stopping TKI-therapy, TKI-reimbursement policies, TKI-related adverse effects and long-term efficacy of TKIs. 12 issues attracted proportionally discordant attention between patients and hematologists. Patients were more concerned with TKI-reimbursement policies, price reduction of TKIs, TKI-related adverse effects, restrictions to daily life, CML knowledge and interpretation of laboratory data, whereas hematologists were more concerned with stopping TKI-therapy, TKI choice, monitoring, TKI dose-adjustment, quality of generics and switching between branded and generic TKIs. In multivariate analyses female sex [OR = 1.4 (1.1–1.7); p = 0.008], education level ≥ bachelor e[OR = 1.8 (1.4–2.2); p < 0.001], TKI-therapy duration 36–< 60 months [OR = 1.4 (1.0–1.9); p = 0.049] and having adverse impact on daily life and work [OR = 1.5 (1.2–1.8]; p = 0.001] were associated with greater numbers of patients’ concerns.


Our data suggested hematologists need to be aware of CML patients’ concerns to improve their quality-of-life and patient-hematologist communication.


Chronic myeloid leukemia Tyrosine kinase inhibitor Concern 



The results of this study were presented in part at the American Society of Hematology (ASH) Annual Meeting in San Diego, December 3–6, 2016. This study was funded by National Natural Science Foundation of China (No. 81370637).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies 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. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

432_2018_2594_MOESM1_ESM.pdf (143 kb)
Supplementary material 1 (PDF 143 KB)
432_2018_2594_MOESM2_ESM.pdf (200 kb)
Supplementary material 2 (PDF 200 KB)
432_2018_2594_MOESM3_ESM.pdf (269 kb)
Supplementary material 3 (PDF 268 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Peking University People’s HospitalPeking University Institute of HematologyBeijingChina
  2. 2.Collaborative Innovation Center of HematologySoochow UniversitySuzhouChina
  3. 3.Haematology Research Centre, Division of Experimental Medicine, Department of MedicineImperial College LondonLondonUK

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