The link between treatment outcomes and quality of life in patients with chronic myeloid leukemia under tyrosine kinase inhibitor therapy

The study examined whether health-related quality of life (HRQoL) relates to the molecular response (MR) to tyrosine kinase inhibitors (TKIs) in patients with chronic-phase chronic myeloid leukemia (CP-CML). The authors found that improved MR had differential effects on HRQoL in such patients.

TKIs are a treatment used for CP-CML. They deactivate a cancerous enzyme called BCR-ABL. TKIs improve survival in patients with CP-CML during lifelong therapy. Patients’ HRQoL is therefore considered while selecting treatments.

Major molecular response (MMR) is achieved when 1 in 1000 blood cells is left with BCR-ABL after treatment. The TKI Bosutinib (Bosulif) caused a higher MMR rate in patients with CP-CML than another TKI Imatinib (Gleevec). HRQoL was also maintained. However, the link between MR and HRQoL in patients with CP-CML under TKI treatment is unclear.

The study analyzed data from 536 adult patients with newly diagnosed CP-CML. Patients received 400 mg daily dose of either bosutinib or imatinib for 5 years. All patients reported their HRQoL based on physical, social, emotional, functional, and leukemia-related well-being. They were scored by FACT-Leu scale. Higher scores meant better HRQoL. MR was assessed by detecting BCR-ABL levels in the blood. It was scored by the MRLR scale between 0 to -5. Lower scores referred to better MR.

The relationship between MRLR and total FACT-Leu scores was linear in all patients. Meaning that patients with better MR to TKIs had improved overall HRQoL. Patients achieving deep MR had the highest MRLR scores. The clinical impact of total FACT-Leu scores was the highest in this patient group.

The study concluded that improved MR was linked to overall better HRQoL in patients with newly diagnosed CP-CML treated with TKIs. Emotional and leukemia-related well-being were greatly improved in patients with MR. Whereas social and physical aspects were poorly related to MR.

The study was retrospective meaning that it looked back in time to analyze patients’ data. Evaluating HRQoL’s link to MR can be done simultaneously with clinical trials in the future.