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Relationship between molecular response and quality of life with bosutinib or imatinib for chronic myeloid leukemia.

  • Brümmendorf, Tim H1
  • Gambacorti-Passerini, Carlo2
  • Bushmakin, Andrew G3
  • Cappelleri, Joseph C3
  • Viqueira, Andrea4
  • Reisman, Arlene5
  • Isfort, Susanne6
  • Mamolo, Carla3
  • 1 Universitätsklinikum RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany. [email protected] , (Germany)
  • 2 University of Milano-Bicocca, Monza, Italy. , (Italy)
  • 3 Pfizer Inc, Groton, CT, USA.
  • 4 Pfizer SLU, Madrid, Spain. , (Spain)
  • 5 Pfizer Inc, New York, NY, USA.
  • 6 Universitätsklinikum RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany. , (Germany)
Published Article
Annals of Hematology
Publication Date
Apr 19, 2020
DOI: 10.1007/s00277-020-04018-1
PMID: 32307568


Patients with newly diagnosed chronic phase chronic myeloid leukemia (CP CML) can be effectively treated with tyrosine kinase inhibitors (TKIs) and achieve a lifespan similar to the general population. The success of TKIs, however, requires long-term and sometimes lifelong treatment; thus, patient-assessed health-related quality of life (HRQoL) has become an increasingly important parameter for treatment selection. Bosutinib is a TKI approved for CP CML in newly diagnosed adults and in those resistant or intolerant to prior therapy. In the Bosutinib Trial in First-Line Chronic Myelogenous Leukemia Treatment (BFORE), bosutinib demonstrated a significantly higher major molecular response rate compared with imatinib, with maintenance of HRQoL (measured by the Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) questionnaire), after 12 months of first-line treatment. We examined relationships between molecular response (MR) and HRQoL. MR values were represented by a log-reduction scale (MRLR; a continuous variable). A repeated-measures longitudinal model was used to estimate the relationships between MRLR as a predictor and each FACT-Leu domain as an outcome. Effect sizes were calculated to determine strength of effects and allow comparisons across domains. The majority of FACT-Leu domains (with the exception of social well-being and physical well-being) demonstrated a significant relationship with MRLR (p < 0.05). Our results showed variable impact of clinical improvement on different dimensions of HRQoL. For patients who achieved MR5, emotional well-being and leukemia-specific domains showed the greatest improvement, with medium differences in effect sizes, whereas social well-being and physical well-being had the weakest relationship with MR.

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