在使用酪氨酸激酶抑制剂治疗慢性髓性白血病期间,患者与医生在管理慢性髓性白血病方面的观点对比。

IF 3.2 Q2 ONCOLOGY Oncology and Therapy Pub Date : 2024-03-01 Epub Date: 2023-12-16 DOI:10.1007/s40487-023-00255-2
Hong Chen, Yan Wen, Yun Zeng, Lie Lin, Bihong Sun, Hongqian Zhu, Huiqing He, Xiaotao Wang, Waiyi Zou, Caifeng Zheng, Liling Zheng, Jinxiong Huang, Liping Pang, Jixian Huang, Yuming Zhang, Haiqing Lin, Zelin Liu, Wanshou Zhu, Qiang Wang, Xuan Zhou, Xiaoli Liu, Hong Qu, Zhenfang Liu, Xin Du, Na Xu
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引用次数: 0

摘要

简介慢性髓性白血病(CML)是一种慢性疾病,无治疗缓解(TFR)日益被视为可行的治疗目标。然而,各种因素可能会影响对国际 CML 管理指南的遵守。本研究旨在比较 CML 患者和他们的主治医生之间的护理报告:方法:2021 年 9 月 22 日至 2022 年 3 月 15 日期间,对患者和医生进行了平行在线调查,重点调查了 1882 名 CML 成年患者和 305 名医生对酪氨酸激酶抑制剂(TKI)治疗方案、监测和毒性、TFR 以及面临的挑战的看法:在登记的患者中,69.9%接受了伊马替尼一线治疗,18.6%接受了尼罗替尼治疗,4.7%接受了达沙替尼治疗。在接受伊马替尼治疗的患者中,36.7%的患者由于伊马替尼耐药/不耐受(71.1%)、为达到TFR而探索更强效的TKIs(8.9%)以及主治医生的建议(14.0%)而转用其他TKIs,初始治疗的中位持续时间为14个月[四分位距(IQR)6-36]。大多数(91.8%)医生同意每 3 个月评估一次断点簇区-Abelson 1(BCR::ABL1)转录本水平,但只有 42.7% 的患者坚持每 3 个月检测一次,只有 17.8% 的患者严格遵照主治医生的建议。半数患者的目标是获得 TFR,但只有 45.2% 的医生将 TFR 视为患者的三大目标之一。获得 TFR 的主要问题是患者的依从性。使用 TKIs 的患者经常感到疲劳,而医生则更关注血小板和中性粒细胞计数。共有12%和20.8%的患者分别报告了中度/重度焦虑和抑郁,而只有53.7%的医生关注患者的心理健康。在冠状病毒病 2019(COVID-19)大流行期间,69.2% 的患者报告收入减少。在这些患者中,61.8%的人维持现有治疗,7.3%的人改用更便宜的替代品或中断治疗,其中超过80%的患者属于低收入群体:结论:克服医患沟通和治疗机会方面的挑战是改善疾病管理和生活质量的关键,尤其是对低收入患者而言:试验注册:ClinicalTrials.gov标识符NCT05092048。
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Patient Versus Physician Perspective in the Management of Chronic Myeloid Leukemia During Treatment with Tyrosine Kinase Inhibitors.

Introduction: Chronic myeloid leukemia (CML) is a chronic disease with treatment-free remission (TFR) increasingly regarded as a feasible goal of treatment. However, various factors may influence adherence to international guidelines for CML management. This study aimed to compare the reporting of care between patients with CML and their treating doctors.

Methods: Parallel patient and physician online surveys were conducted between September 22, 2021, and March 15, 2022, which focused on the perceptions of 1882 adult patients with CML and 305 physicians regarding tyrosine kinase inhibitor (TKI) treatment options, monitoring and toxicities, TFR, and challenges faced.

Results: Among the enrolled patients, 69.9% received first-line imatinib treatment, 18.6% received nilotinib, and 4.7% received dasatinib. Among the patients treated with imatinib, 36.7% switched to other TKIs due to imatinib resistance/intolerance (71.1%), exploration of more potent TKIs to achieve TFR (8.9%), and treating physicians' recommendation (14.0%), with a median duration of initial treatment of 14 months [interquartile range (IQR) 6-36]. Most (91.8%) physicians agreed that the breakpoint cluster region-Abelson 1 (BCR::ABL1) transcript level should be assessed every 3 months, but only 42.7% of individuals committed to 3-monthly testing and only 17.8% strictly followed their treating physicians' recommendation. Half of the patients aimed for TFR; however, just 45.2% of physicians considered TFR as one of the top three goals for their patients. The major concern in obtaining TFR was patients' adherence. Fatigue was often distressing for patients with TKIs, while physicians were more concerned about platelet and neutrophil counts. A total of 12% and 20.8% of patients reported moderate/severe anxiety and depression, respectively, while only 53.7% of physicians had concerns about their patients' mental health. During the coronavirus disease 2019 (COVID-19) pandemic, 69.2% of patients reported a reduction in their income. Among these patients, 61.8% maintained their current treatment, while 7.3% switched to cheaper alternatives or discontinued treatment, with over 80% of these patients belonging to the low-income group.

Conclusions: Overcoming challenges in patient-physician communication and treatment access is key to improving disease management and quality of life, especially for patients with low income.

Trial registration: ClinicalTrials.gov identifier NCT05092048.

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来源期刊
CiteScore
3.40
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0.00%
发文量
31
审稿时长
6 weeks
期刊介绍: Now indexed in PubMed Aims and Scope Oncology and Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality pre-clinical, clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Oncology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Rapid Publication The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid and efficient communication of the latest research and reviews, allowing the advancement of clinical therapies. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning that authors will always have a personal point of contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. We also encourage pre-submission enquiries and are always happy to provide a confidential assessment of manuscripts. Digital features and plain language summaries Oncology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. Preprints We encourage posting of preprints of primary research manuscripts on preprint servers, authors'' or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. Please see here for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550 Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case by case basis and should be sent to the journal editor. Copyright Oncology and Therapy''s content is published open access under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0 Publication Fees Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of £3650/€4500/$5100. The journal will consider fee discounts for developing countries and this is decided on a case by case basis. Open Access All articles published by Oncology and Therapy are published open access Contact For more information about the journal, including pre-submission enquiries, please contact managing editor Lydia Alborn at lydia.alborn@springer.com.
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