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Chronic myelogenous leukemia

Health-related quality of life of newly diagnosed chronic myeloid leukemia patients treated with first-line dasatinib versus imatinib therapy

Leukemia volume 34, pages 488–498 (2020)Cite this article

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Abstract

There is paucity of evidence-based data on health-related quality of life (HRQOL) outcomes of chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKIs). We performed a multicenter propensity-matched case-control study to compare HRQOL of newly diagnosed CML patients treated with front-line dasatinib (cases) or imatinib (controls). Patient-reported HRQOL was assessed with the EORTC QLQ-C30 and the EORTC QLQ-CML24 questionnaires. The impact on daily life scale of the EORTC QLQ-CML24 was selected a priori in the protocol as the primary HRQOL scale for the comparative analysis. Overall, 323 CML patients were enrolled of whom 223 in therapy with imatinib and 100 in therapy with dasatinib. Patients treated with dasatinib reported better disease-specific HRQOL outcomes in impact on daily life (Δ = 8.72, 95% confidence interval [CI]: 3.17–14.27, p = 0.002), satisfaction with social life (Δ = 13.45, 95% CI: 5.82–21.08, p = 0.001), and symptom burden (Δ = 7.69, 95% CI: 3.42–11.96, p = 0.001). Analysis by age groups showed that, in patients aged 60 years and over, differences favoring dasatinib were negligible across several cancer generic and disease-specific HRQOL domains. Our findings provide novel comparative HRQOL data that extends knowledge on safety and efficacy of these two TKIs and may help to facilitate first-line treatment decisions.

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Acknowledgements

We would like to thank all the patients who participated in this study. We also acknowledge Giora Sharf and Felice Bombaci from the CML Advocates Network for their help in the initial setting up of the study.

Funding

This study was supported in part by the Bristol Myers Squibb (BMS). BMS had no role in the design and conduct of this study; collection, management, analysis, and interpretation of data presented; and preparation, review, or approval of this manuscript.

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Authors and Affiliations

  1. Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy

    Fabio Efficace, Francesco Cottone & Marco Vignetti

  2. Hematology Section with BMT Unit, AOU Policlinico—V. Emanuele, Catania, Italy

    Fabio Stagno

  3. Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Alessandra Iurlo

  4. Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Rome, Italy

    Massimo Breccia

  5. Department of Medicine, Section of Hematology, University of Verona, Verona, Italy

    Massimiliano Bonifacio

  6. Division of Hematology, Ospedale S. Eugenio, Roma, Italy

    Elisabetta Abruzzese

  7. Institute of Hematology “L. & A. Seràgnoli”, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Sant’Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy

    Fausto Castagnetti & Gianantonio Rosti

  8. Dipartimento Scienze Mediche e Sanità Pubblica, Università di Cagliari, Ospedale Businco, Cagliari, Italy

    Giovanni Caocci

  9. Division of Hematology and BMT, Parma University, Parma, Italy

    Monica Crugnola

  10. Division of Hematology, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy

    Isabella Capodanno

  11. GOM Bianchi-Melacrino-Morelli, Reggio Calabria, Italy

    Bruno Martino

  12. Division of Hematology and BMT, Department of Medical Area, University of Udine, Udine, Italy

    Mario Tiribelli

  13. Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy

    Andrea Patriarca

  14. Hematology Unit, AOU Careggi, University of Florence, Florence, Italy

    Antonella Gozzini

  15. Hematology Division, Azienda Ospedaliera Città della Salute e della Scienza, Torino, Italy

    Patrizia Pregno

  16. III. Med. Klinik, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Susanne Saussele

  17. Department of Hematology and Stem Cell Transplant Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy

    Nicola Cascavilla

  18. Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy

    Claudio Fozza

  19. Clinic of Hematology, Department of Internal Medicine (DiMI), Policlinico San Martino-IST, Genoa, Italy

    Micaela Bergamaschi

  20. Hematology and Clinical Immunology Unit, Department of Medicine, Padua School of Medicine, Padua, Italy

    Gianni Binotto

Authors
  1. Fabio Efficace
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  2. Fabio Stagno
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  14. Andrea Patriarca
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  21. Gianni Binotto
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  22. Marco Vignetti
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  23. Gianantonio Rosti
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Contributions

Conception and design: FE, FC, GR. Data analysis and interpretation: All authors. Statistical analysis: FC, FE. Manuscript writing: All authors. Final approval of manuscript: All authors.

Corresponding author

Correspondence to Fabio Efficace.

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Conflict of interest

FE: Consultancy: BMS, Amgen, Orsenix, Incyte and Takeda. MBr: Honoraria: Novartis, BMS, Pfizer, Incyte, Celgene. MBo: Research funding: Novartis; Consultancy: Bristol Myers Squibb. FCa: Consultancy: Novartis, Bristol Myers Squibb, Pfizer, Incyte; Honoraria: Novartis, Bristol Myers Squibb, Pfizer, Incyte. MC: Honoraria: Incyte, Novartis, Celgene, Amgen. AP: Research funding: Novartis. SS: Research funding: Novartis, Bristol Myers Squibb, Incyte; Honoraria: Novartis, Bristol Myers Squibb, Incyte, Pfizer. GB: Honoraria: Incyte, Pfizer, Bristol Myers Squibb, Novartis. GR: Honoraria: Novartis, Bristol Myers Squibb, Pfizer, Incyte. MV: Consultancy and Advisory board: Jazz Healthcare, Millennium Pharmaceuticals. Educational meeting: Pfizer

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Efficace, F., Stagno, F., Iurlo, A. et al. Health-related quality of life of newly diagnosed chronic myeloid leukemia patients treated with first-line dasatinib versus imatinib therapy. Leukemia 34, 488–498 (2020). https://doi.org/10.1038/s41375-019-0563-0

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