HEALTH-RELATED QUALITY OF LIFE IN CHRONIC MYELOID LEUKAEMIA PATIENTS RECEIVING LONG-TERM THERAPY WITH DIFFERENT TYROSINE KINASE INHIBITORS IN KURDISTAN REGION.

Abstract

Background: Chronic myeloid leukaemia (CML) treatment was revolutionized by tyrosine kinase inhibitors (TKIs), reducing annual mortality from 10-20% to 1-2%. This study assessed health-related quality of life (HRQoL) in patients receiving long-term TKI therapy in the Kurdistan region of Iraq.

Methods: This observational study included 161 adult CML patients (90 males, 71 females, mean age 46.1 years) across three hospitals from January to August 2024. HRQoL was assessed using EORTC QLQ-C30 and QLQ-CML24 questionnaires, comparing outcomes between different TKIs (Imatinib, Nilotinib, and Bosutinib), gender, age groups, and comorbidity impacts.

Results: Imatinib patients showed better emotional functioning than Bosutinib (80 vs. 73, p=0.027). Female patients reported more severe symptoms across multiple domains, while males demonstrated better physical, emotional, and cognitive functioning. Younger patients (<40 years) showed better HRQoL outcomes. Increasing comorbidities correlated with decreased functional scales and increased symptom burden. Significant differences were observed in pain, diarrhoea, and constipation between TKI groups.

Conclusion: While CML patients maintain a relatively good quality of life on TKI therapy, persistent impairments remain in certain domains. Younger age and fewer comorbidities were associated with better outcomes. Gender-specific approaches to supportive care and comprehensive health management beyond CML treatment are recommended. These findings can inform clinical decision-making and identify areas for targeted interventions to enhance the quality of life in CML patients.