Fear of Progression in Outpatients With Chronic Myeloid Leukemia on Oral Tyrosine Kinase Inhibitors

Abstract

Nurses should be vigilant about FoP in this population. Established questionnaires may help to identify and evaluate this frequent source of distress. Specific communication could reveal unmet informational needs and may help to initiate interventions. Additional studies are needed to confirm the numbers in a larger cohort of patients, to examine the prevalence during the course of disease, to search for potential influences on the outcome (i.e., via adherence), and to extract the best interventions.

Medication-related issues associated with adherence to long-term tyrosine kinase inhibitors for controlling chronic myeloid leukemia: a qualitative study

“…This accords with previous reports identifying nausea as a major cause of nonadherence to imatinib 16,26. Concern raised by patients over the long-term safety of TKIs is also in keeping with a German survey that found that the fear of harmful effects from TKIs ranked even higher than the fear of CML progression 27. While Chen et al17 reported that knowledge of potential for drug resistance served as a positive motivation for sustaining imatinib adherence among Taiwanese CML patients, the present study showed contradictory findings.…”

Adherence and Coping Strategies in Outpatients With Chronic Myeloid Leukemia Receiving Oral Tyrosine Kinase Inhibitors

“…A prospective and descriptive study design was adopted for this explorative study. The dataset used belonged to a larger parent study (Hefner, Csef, & Kunzmann, 2016) in which outpatients with CML were screened for distress, adherence, and coping mechanisms. In 37 outpatients with CML, the authors already have shown that fear of progression provides a frequent source of distress, most often generated by fear (Hefner et al, 2016).…”

“…Sociodemographic data, including age, gender, and marital status, were obtained using an established questionnaire (Deck & Röckelein, 1999). Patients aged 60 years and older were defined as older adults (Hefner et al, 2016). Current TKI side effects and CML remission status were assessed during the patients' visits.…”

“…Current TKI side effects and CML remission status were assessed during the patients' visits. Side effects were defined as cytopenia grades 3-4, and all grades of fatigue, fluid retention, cardiopulmonary abnormalities, myalgia, arthralgia, nausea, vomiting, diarrhea, or rash (Hefner et al, 2016). Medical history was obtained from charts.…”

“…Medical history was obtained from charts. Oral TKIs were categorized into first-generation (imatinib), secondgeneration (dasatinib, nilotinib, and bosutinib), and third-generation TKIs (ponatinib) (Hefner et al, 2016).…”