title: Rationale and protocol of CML study: cognitive and emotional impact of discontinuation of therapy in patients with chronic myeloid leukemia.
abstract: BACKGROUND
  Discontinuation of therapy can be proposed to patients with chronic myelogenous leukemia (CML) who reach a sustained deep molecular response (DMR) for a minimum and stable period. Today, a considerable number of patients reach a sustained DMR, especially when they are treated with the latest drugs. Although new-generation treatments may provide significant improvement in terms of patient health and health-related quality of life, many patients are uncertain about discontinuation and may refuse a treatment switch.
  
  
  METHODS
  This study is an observational research project aimed at investigating, from a psychological point of view, possible cognitive and emotional components that can influence treatment discontinuation and treatment decisions in a cohort sample of 120 CML patients.
  
  
  RESULTS
  The expected results indicate that cognitive and emotional factors may influence decision-making in this setting and may prevent appropriate risk-and-benefit evaluation of new treatment approaches.
  
  
  CONCLUSIONS
  This is the first study that will analyze in depth all possible psychological variables that can interfere with the medical decision process of treatment discontinuation in CML, providing new insights for clinical practice.
authors.affiliation: Department of Oncology and Hemato-oncology, University of Milan, Milan - Italy.|Applied Research Division for Cognitive and Psychological Sciences, European Institute of Oncology (IEO), Milan - Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Riva
authors.affiliation: Department of Oncology and Hemato-oncology, University of Milan, Milan - Italy.|Applied Research Division for Cognitive and Psychological Sciences, European Institute of Oncology (IEO), Milan - Italy.
authors.forename: Ketti
authors.initials: K
authors.lastname: Mazzocco
authors.affiliation: Department of Oncology and Hemato-oncology, University of Milan, Milan - Italy.|Applied Research Division for Cognitive and Psychological Sciences, European Institute of Oncology (IEO), Milan - Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Pravettoni
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000066491:Clinical Decision-Making; D003071:Cognition; D004644:Emotions; D005060:Europe; D005260:Female; D006801:Humans; D007391:International Cooperation; D007558:Italy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D010551:Personality; D010555:Personality Inventory; D011446:Prospective Studies; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011788:Quality of Life; D028761:Withholding Treatment
chemical_list: D000970:Antineoplastic Agents; D011505:Protein-Tyrosine Kinases