Influencing Factors Of Health-related Quality Of Life In Patients With Chronic Myeloid Leukemia In Jilin Province

Objective:To evaluate the health-related quality of life（HRQOL）in patients with chronicphase Chronic myeloid leukemia（CML）receiving Tyrosine kinase inhibitors（TKI）in Jilin Province,explore the influencing factors of quality of life,so as to provide some refence for clinical targeted treatment and improving the quality of life of patients.Methods:The sociodemographic characteristics and clinical characteristics were collected from patients with chronic-phase CML who were followed up in the Hematology Department of the First Hospital of Jilin University from May 2021 to December 2021.The EORTC-QLQ-C30 and EORTC-QLQ-CML24 questionnaires developed by the European Organization for Research and Treatment of Cancer were used to assess the health-related quality of life,including global health status,functional scales（physical,role,emotional,social,and cognitive）,the impact of disease on daily life,symptom burden,impact on worry/mood,body image problems,satisfaction with care and information,and satisfaction with social life.All patients gave informed consent and answered the questions by themselves,and the researcher could explain the meaning of the questions to them.SPSS 26.0 software was used for statistical analysis,and P <0.05 was considered to be statistically significant.Results:A total of 175 patients were enrolled.The median age was 46 years（18-83）.There were 102（58.3%）males.There were 114 patients（65.1%）in urban households and61（34.9%）in rural households;57 patients（32.6%）had monthly income less than 1000 yuan,86 patients（49.1%）had monthly income between 1,000 and 5,000 yuan,and 32patients（18.3%）had monthly income more than 5000 yuan.There were 20 patients（11.4%）with primary school education,82 patients（46.9%）with middle school education,and 73 patients（41.7%）with college education.25 patients（14.3%）were unmarried,141 patients（80.6%）were married and 9 patients（5.1%）were divorced or widowed.The median duration of disease was 44 months（3-221）.21 patients（12.0%）were treated with Gleevec,87 patients（49.7%）with general imatinib,17 patients（9.7%）with dasatinib,31 patients（17.7%）with nilotinib,and 19 patients（10.9%）with flumatinib.Frequent reduction of TKI in 6 patients（3.4%）.There were 43 patients（24.6%）who achieved Complete Cytogenetic Response（CCy R）but failed to achieve Major Molecular Response（MMR）.48 patients（27.4%）who achieved MMR but not Molecular Response 4.0（MR4.0）and 84 patients（48%）were achieved MR4.0.There were 41（23.4%）patients with complications,and 134（76.6%）patients without complications.The univariate analysis results:（1）male patients have a better quality of life than female patients in terms of cognitive function,symptom burden and impact on worry/mood,but female patients were more satisfied with social life than male patients.（2）Patients living in rural have a better quality of life in term of impact on daily life.（3）Patients whose monthly income is less than 1,000 yuan have a poor quality of life in term of poor social function、global health status,and impact on daily life.（4）The patients with college degree have a better quality of life in the field of social function and impact on daily life.However,the higher the education level,the heavier the impact on worry/mood.（5）Patients with disease duration between 36 and 60 months have a poor satisfaction with care and information.（6）Patients with second-generation TKI have a poorer quality of life in term of impact on daily life.（7）The patients who regularly take medicine have a better quality of life in term of social function and global health status.（8）Patients whose treatment effect is not as good as MMR have poorer quality of life in term of impact on daily life.（9）Patients with comorbidities have a poorer quality of life in terms of role function,cognitive function and global health status.Results of multivariate analysis of influencing CML patients’ quality of life:gender,age,monthly income,duration of disease,complications,TKI type and efficacy had an independently impact on quality of life in patients with chronic myeloid leukemia.Conclusions:1.The independent factors associated with higher quality of life in CML patients in Jilin Province were age over 60,higher monthly income and treatment effect of achieving MR4.0,while the independent factors associated with lower quality of life were female,second-generation TKI and comorbidity.2.In clinical treatment,attention should be paid to the management of complications and increase education on disease and treatments soon as possible to improve the quality of life of CML patients.