Foulon S1,2,3, Cony-Makhoul P4,5, Guerci-Bresler A5,6, Daban M7, Kapso R8,9, Tubert-Bitter P10, Bonastre J8,9. 1. Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France. stephanie.foulon@gustaveroussy.fr. 2. Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre Le Cancer, Villejuif, France. stephanie.foulon@gustaveroussy.fr. 3. Université Paris-Saclay, UVSQ, Université Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France. stephanie.foulon@gustaveroussy.fr. 4. Service D'Hématologie, CH Annecy Genevois, Pringy, France. 5. Institut Bergonié, Bordeaux to Pr Franck Nicolini, Centre Léon Bérard, Lyon, France. 6. Service D'Hématologie, CHRU Brabois, Vandoeuvre, France. 7. LMC France, Marseille, France. 8. Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France. 9. Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre Le Cancer, Villejuif, France. 10. Université Paris-Saclay, UVSQ, Université Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France.
Abstract
PURPOSE: Tyrosine kinase inhibitors (TKIs) have dramatically improved the prognosis of chronic myeloid leukemia (CML). We aimed to assess health state utility and quality of life (QoL) in French patients with CML in real-life setting, to study the determinants of utility score and to compare health-related QoL values to general population norms. METHODS: We conducted a cross-sectional study in 412 patients with CML. Data were collected by electronic survey. Three patient-reported outcomes questionnaires were used: EORTC QLQ-C30, EORTC QLQ-CML24 and EuroQol EQ-5D-3L. Health state utility values were computed using the French value set. We computed deviations from reference norms from the general population. We studied the determinants of health utility score using multiple regression models. RESULTS: The mean utility score (SD) was 0.72 (0.25) in the chronic phase and 0.84 (0.21) in treatment-free remission, with marked variations by gender. Patients with CML had a deviation from the reference norm of -0.15 on average (SD: 0.25). In terms of QoL, social functioning, role functioning and cognitive functioning were notably impacted with a mean difference of -16.0, -13.1 and -11.7 respectively. Fatigue, dyspnea and pain were the symptoms with the highest deviation from general population norms (mean difference of 20.6, 14.0 and 8.3 respectively). In the multiple regression analysis, fatigue was the most important independent predictor of the utility score. CONCLUSION: Although TKIs prevent the disease from progressing and even allow remission without treatment, QoL in patients with CML is notably altered. The utility scores deteriorate with CML symptoms.
PURPOSE: Tyrosine kinase inhibitors (TKIs) have dramatically improved the prognosis of chronic myeloid leukemia (CML). We aimed to assess health state utility and quality of life (QoL) in French patients with CML in real-life setting, to study the determinants of utility score and to compare health-related QoL values to general population norms. METHODS: We conducted a cross-sectional study in 412 patients with CML. Data were collected by electronic survey. Three patient-reported outcomes questionnaires were used: EORTC QLQ-C30, EORTC QLQ-CML24 and EuroQol EQ-5D-3L. Health state utility values were computed using the French value set. We computed deviations from reference norms from the general population. We studied the determinants of health utility score using multiple regression models. RESULTS: The mean utility score (SD) was 0.72 (0.25) in the chronic phase and 0.84 (0.21) in treatment-free remission, with marked variations by gender. Patients with CML had a deviation from the reference norm of -0.15 on average (SD: 0.25). In terms of QoL, social functioning, role functioning and cognitive functioning were notably impacted with a mean difference of -16.0, -13.1 and -11.7 respectively. Fatigue, dyspnea and pain were the symptoms with the highest deviation from general population norms (mean difference of 20.6, 14.0 and 8.3 respectively). In the multiple regression analysis, fatigue was the most important independent predictor of the utility score. CONCLUSION: Although TKIs prevent the disease from progressing and even allow remission without treatment, QoL in patients with CML is notably altered. The utility scores deteriorate with CML symptoms.
Entities:
Keywords:
Chronic myeloid leukemia; Health utility score; Quality of life; Tyrosine kinase inhibitor
Authors: Peter C Trask; David Cella; Nadine Besson; Virginia Kelly; Tamás Masszi; Dong-Wook Kim Journal: Leuk Res Date: 2011-10-28 Impact factor: 3.156
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Authors: Stéphanie Foulon; Pascale Cony-Makhoul; Agnès Guerci-Bresler; Marc Delord; Eric Solary; Alain Monnereau; Julia Bonastre; Pascale Tubert-Bitter Journal: Cancer Med Date: 2019-04-30 Impact factor: 4.452