Symptom Burden and Quality of Life Issues among Patients of Chronic Myeloid Leukemia on Long-term Imatinib Therapy

BACKGROUND: Tyrosine kinase inhibitors such as imatinib have improved survival in chronic myeloid leukemia (CML). Imatinib can cause chronic side effects which are not considered serious but can impact the quality of life (QoL) of the patient. METHODS: The results of a detailed symptom burden analysis and its impact on QoL scores in a cohort of patients on long-term imatinib is presented in this study. Symptom burden was assessed using the M. D. Anderson Symptom Inventory specific for CML patients. An indigenously developed QoL questionnaire (Cancer Institute Quality of Life II) was administered simultaneously. RESULTS: Of 221 patients of CML (M:F = 133:88; median age: 39 years [18–65], median duration of imatinib: 4 years), QoL scores were high in 46%, average in 39%, and low in 14%. QoL scores were negatively correlated with general symptoms (r = −0.612, P < 0.001), CML-specific symptoms (r = −0.513, P < 0.001), and interference of symptoms (r = −0.596, P < 0.001). CONCLUSIONS: Significant impairment of QoL was noted among patients with CML primarily due to the burden of symptom related to side effects of imatinib. This issue must be addressed both in the clinic as well as in all studies of CML.