Publication Date:
2012-11-16
Description:
Abstract 4260 Objective: Patients with chronic-phase, Philadelphia chromosome-positive chronic myeloid leukemia (CML) receiving tyrosine kinase inhibitor (TKI) therapy experience symptoms. We investigated the association between patient-reported symptom severity and longitudinal levels of interference with daily functioning. Materials and Methods: In this descriptive, longitudinal study, 156 patients with CML rated the 20 symptom items (13 core cancer and 7 CML-specific symptom items) and 6 interference items of the M. D. Anderson Symptom Inventory for CML (MDASI-CML), on a 0-to-10 scale (0 = not present or no interference; 10 = as bad as can be imagined or complete interference) every 2 weeks for 1 year. Group-based trajectory analysis was used to describe the longitudinal patient-reported interference of symptoms with daily functioning. We used univariate mixed modeling to describe the relationship between symptom severity at time of study entry and patient-reported functional interference across time. These analyses were adjusted for patient factors (age, sex, race, marital status, employment, and time since diagnosis). Results: Mean participant age was 51.1 years (standard deviation [sd]=13.5) and mean years of education was 14.6 (sd=2.3); 72 participants (46%) were male; 116 (74%) were white non-Hispanic with 13 (8%) black non-Hispanic, 15 (9%) Hispanic, and 12 (8%) other races; 124 (80%) were married or lived with another adult; 92 (59%) were employed full or part time, 15 (10%) were homemakers, 26 (17%) were retired, 17 (11%) were on a medical leave of absence or medically disabled, and 6 (4%) were unemployed. Participants were mostly in the chronic phase of CML (95.5%), were receiving TKI therapy (98%), had been diagnosed for a mean of 6.1 years (sd=4.74), and been on TKI therapy for a mean of 4.1 years (sd=3.13) before study entry. Most participants had little evidence of disease with 123 (79%) having a complete cytogenetic response and 81 (52%) having a complete molecular response by polymerase chain reaction at time of study entry. Fatigue (mean=2.93, sd=2.67) was persistently the most severe symptom, followed by disturbed sleep (mean=2.19, sd=2.59), drowsiness (mean=2.07, sd=2.40), muscle cramping (mean=2.02, sd=2.46), and difficulty remembering (mean=1.81, sd=2.17). The highest interference reported was with work (mean=1.69, sd=2.41), followed by general activity (mean=1.67, sd=2.32) and mood (mean=1.50, sd=2.15). Trajectory analysis showed that 69 (43%) participants were in a higher interference group (mean interference=3.01, sd=1.60) and that the remaining 87 (54%) were in a distinctly lower interference group (mean=0.50, sd=0.44) (Figure 1). None of the demographic characteristics or time since diagnosis predicted patient interference scores. Eleven symptom scores at study entry significantly predicted interference scores (pain, p=0.0009; fatigue, p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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