title: Quality of life in chronic myeloid leukaemia patients after haematopoietic cell transplantation pretreated with second-generation tyrosine kinase inhibitors.
abstract: OBJECTIVE
  The majority of patients with chronic myeloid leukaemia (CML) respond to tyrosine kinase inhibitors (TKI), while allogeneic haematopoietic cell transplantation (HCT) is indicated in selected clinical situations. HCT carries the risk of severe complications, while the toxicity profile of dasatinib and nilotinib may lead to adverse reactions affecting the quality of life (QoL). We present the results of observational analysis of CML patients who underwent HCT after exposure to second-generation TKI (TKI2), with respect to their quality of life assessed comparatively after transplantation.
  
  
  METHODS
  Eligible subjects included 19 patients. The quality of life and global health assessment were performed with a questionnaire comparing the signs and symptoms present during the TKI2-therapy with those related to post-transplant complications, including psychosocial problems.
  
  
  CONCLUSIONS
  Most patients had no/few problems with exhausting activities, no/few difficulties during long-distance walks, and do not/rarely rest in the daytime. Seventeen (89.5%) patients reported at least one symptom related to TKI2-therapy and most of them disappeared after HCT. Thirteen (68.4%) patients noted no serious complication after HCT. Most patients claimed to have a very good QoL and general health compared to the period prior to HCT. We found statistically significant improvement in global health (p= 0.016) and QoL (p= 0.043) after HCT. From the survivors perspective, HCT influence positively general health and QoL comparing to TKI2-therapy period. Further studies on larger group of patients will more precisely define the QoL level and possible predictors of changes in QoL, to assess which group of patients needs psychological support.
authors.affiliation: Department of Hematology and Transplantology, Medical University of Gdańsk, University Clinical Center, Gdansk, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Piekarska
authors.affiliation: Department of Haematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Lidia
authors.initials: L
authors.lastname: Gil
authors.affiliation: Department of Hematology and Transplantology, Medical University of Gdańsk, University Clinical Center, Gdansk, Poland.
authors.forename: Karolina
authors.initials: K
authors.lastname: Jakitowicz
authors.affiliation: Department of Hematology and Transplantology, Medical University of Gdańsk, University Clinical Center, Gdansk, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Prejzner
authors.affiliation: Department of Haematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Mieczysław
authors.initials: M
authors.lastname: Komarnicki
authors.affiliation: Department of Hematology and Transplantology, Medical University of Gdańsk, University Clinical Center, Gdansk, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Hellmann
keywords: allogeneic hematopoietic cell transplantation; quality of life; tyrosine kinase inhibitors