Quality of life of chronic myeloid leukemia patients in Brazil: ability to work as a key factor

Since the development of imatinib and other tyrosine kinase inhibitors (TKIs), the prognosis for patients with chronic myeloid leukemia (CML) has markedly improved, such that most patients diagnosed with CML can now expect to live with their disease rather than die from it. However, most patients will require long term treatment, which has deleterious effects on health-related quality of life. We review recent literature on drug-related adverse effects, long term medication adherence, limitations to fertility and pregnancy, effects on cognitive function, ability to work, financial toxicity, pediatric populations, and treatment discontinuation. While patients with CML are fortunate to have excellent therapies available to control their disease, many are unable to lead normal lives, which challenges the notion that research is no longer needed in CML. Curing CML, i.e., no detectable disease and no need for daily medications, should remain the ultimate goal.

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“…This is important because the ability to work was also associated with higher scores on the FACT-G (p<0.001) and the FACT-Leu (p<0.001). 28 …”

Section: Ability To Workmentioning

confidence: 99%

Quality of Life and Long-Term Therapy in Patients with Chronic Myeloid Leukemia

Flynn

Atallah

2016

Curr Hematol Malig Rep

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“…These data show the need for additional health information to promote a better understanding by patients of the importance of their adherence to treatment, as the disease requires daily and rigorous use of oral medication. On the other hand, the ability to work proved to be an essential component in the quality-of-life of CML patients 15 …”

Section: Discussionmentioning

confidence: 99%

Incidence and spatial distribution of Chronic Myeloid Leukemia by regions of economic development in the state of Pernambuco, Brazil

Neves¹,

Brito²,

Vasconcelos

et al. 2019

Hematology, Transfusion and Cell Therapy

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Background The establishment of regional development poles in the State of Pernambuco, Brazil was characterized by industrial expansion and consequent concerns about the increase in the occurrence of diseases, specifically those having long latency periods, as is the case of Chronic Myeloid Leukemia. Methods The study included 367 patients diagnosed with Chronic Myeloid Leukemia over a ten-year period at a reference treatment center. Records of patient charts and the TerraView software were used, respectively, for data collection and geographic mapping of the cases from the twelve established State development regions. Results A total incidence of 3.4 cases per 100,000 inhabitants was found, with a predominance of the disease among males, a median age of 47 years, a mestizo ethnicity, with elementary schooling and residence in urban area. Microregional incidence varied, but there was no significant variation in numbers over the years, and no relevant socio-environmental determinants were identified. Conclusion The present study determined the incidence and characterized the spatial distribution of Chronic Myeloid Leukemia cases over a decade in a northeastern Brazilian state. The variation in the incidence rate by region of development is compatible with a homogeneous distribution of the cases. The work is a baseline study to be used for present and future analyses of the impact of the state economic development poles and the occurrence of this chronic malignant disease.

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“…Such a framework emphasizes identifying treatment approaches that restore patient function and consequently the economic value of therapy to the patient and society, thereby indirectly offsetting higher costs of treatment. Although not yet widely used to compare proton therapy versus IMRT, engaging studies through the lens of this framework would represent a patient-centered lens when comparing cost of illness, a lens that has already been applied for evaluating the value of systemic and targeted therapies for cancer of other disease sites [ 39 , 40 ]. Our research group, conducting the ongoing randomized trial of proton versus photon treatment for oropharyngeal cancer patients (NCT01893307) [ 41 ], is evaluating patients' work and productivity outcomes after chemoradiation as a secondary outcome.…”

Section: Addressing the Economic Impact Of Proton Therapymentioning

confidence: 99%

Financial Toxicity in Head and Neck Cancer Patients Treated With Proton Therapy

Smith

Shih

Frank

2021

International Journal of Particle Therapy

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Cancer-related financial toxicity impacts head and neck cancer patients and survivors. With increasing use of proton therapy as a curative treatment for head and neck cancer, the multifaceted financial and economic implications of proton therapy—dimensions of “financial toxicity”—need to be addressed. Herein, we identify knowledge gaps and potential solutions related to the problem of financial toxicity. To date, while cost-effectiveness analysis has been used to assess the value of proton therapy for head and neck cancer, it may not fully incorporate empiric comparisons of patients' and survivors' lost productivity and disability after treatment. A cost-of-illness framework for evaluation could address this gap, thereby more comprehensively identifying the value of proton therapy and distinctly incorporating a measurable aspect of financial toxicity in evaluation. Overall, financial toxicity burdens remain understudied in head and neck cancer patients from a patient-centered perspective. Systematic, validated, and accurate measurement of financial toxicity in patients receiving proton therapy is needed, especially relative to conventional photon-based strategies. This will enrich the evidence base for optimal selection and rationale for payer coverage of available treatment options for head and neck cancer patients. In the setting of cancer care delivery, a combination of conducting proactive screening for financial toxicity in patients selected for proton therapy, initiating early financial navigation in vulnerable patients, engaging stakeholders, improving oncology provider team cost communication, expanding policies to promote price transparency, and expanding insurance coverage for proton therapy are critical practices to mitigate financial toxicity in head and neck cancer patients.

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Quality of life of chronic myeloid leukemia patients in Brazil: ability to work as a key factor

Abstract: A recent change in medication can improve quality of life. The ability to work is an important component of quality of life of patients with CML. Ability to work should be specifically considered in CML treatment.

Cited by 11 publications

References 39 publications

Quality of Life and Long-Term Therapy in Patients with Chronic Myeloid Leukemia

Quality of Life and Long-Term Therapy in Patients with Chronic Myeloid Leukemia

Incidence and spatial distribution of Chronic Myeloid Leukemia by regions of economic development in the state of Pernambuco, Brazil

Financial Toxicity in Head and Neck Cancer Patients Treated With Proton Therapy

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