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

Authors
  • 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)
Type
Published Article
Journal
Annals of Hematology
Publisher
Springer-Verlag
Publication Date
Apr 19, 2020
Identifiers
DOI: 10.1007/s00277-020-04018-1
PMID: 32307568
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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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