title: Young age and high cost are associated with future preference for stopping tyrosine kinase inhibitor therapy in Chinese with chronic myeloid leukemia.
abstract: OBJECTIVE
  To explore therapy-goals and patients' expectations regarding discontinuing tyrosine kinase inhibitors (TKIs) therapy in Chinese with chronic myeloid leukemia (CML). To identify variables associated with these expectations and preferences.
  
  
  METHODS
  Noninterventional, cross-sectional study using questionnaires distributed to persons with CML and answered anonymously.
  
  
  RESULTS
  With CML in chronic phase, 888 respondents were evaluable. In total, 513 respondents (58 %) were male. Median age was 41 years (range 18-88 years). Median TKI therapy duration was 3 years (range <1-13 years). In total, 735 respondents (83 %) paid part or all of the cost of TKI. As their treatment goal, 430 of 888 respondents (48 %) reported treatment-free remission (TFR). In the future, 734 respondents (83 %) expected to discontinue TKI. Multivariate analyses confirmed younger age [HR = 1.3; (1.1, 1.4); P < 0.001] and higher out-of-pocket expense [HR = 1.2; (1.1, 1.4); P < 0.001] were associated with TFR as a therapy-goal. Both variables were also associated with patients' hope to stop TKI therapy in the future: HR = 1.4; (0.8, 1.7; P < 0.001) and HR = 1.5; (1.3, 1.8; P < 0.001). Achieving a complete molecular response [HR = 1.8 (1.1, 2.9); P = 0.017] and decreased quality of life resulting from adverse effects [HR = 1.2; (1.0, 1.5); P = 0.021] were factors associated with the expectation of discontinuing TKI therapy.
  
  
  CONCLUSIONS
  Younger age and higher out-of-pocket cost are associated with patients' preference for stopping TKI therapy.
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, 11 Xizhimen South Street, Beijing, 100044, China. jiangqian@medmail.com.cn.|Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China. jiangqian@medmail.com.cn.
authors.forename: Qian
authors.initials: Q
authors.lastname: Jiang
authors.affiliation: New Sunshine Charity Foundation, Beijing, China.
authors.forename: Zheng-Chen
authors.initials: ZC
authors.lastname: Liu
authors.affiliation: New Sunshine Charity Foundation, Beijing, China.
authors.forename: Song-Xin
authors.initials: SX
authors.lastname: Zhang
authors.affiliation: Division of Experimental Medicine, Department of Medicine, Haematology Research Centre, Imperial College London, London, UK.
authors.forename: Robert Peter
authors.initials: RP
authors.lastname: Gale
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002681:China; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases
keywords: Chronic myeloid leukemia; Dasatinib; Imatinib; Nilotinib; Tyrosine kinase inhibitors