![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
Abstract
Background
AML is a rapidly progressing bone marrow cancer, with poor survival rates compared to other types of leukemia. IC and NIC as well as BSC treatment options are available; however, there is scant published literature on the impact of disease and treatment on the HRQoL in patients receiving NIC.
Aim
This study determined the HRQoL among NIC AML patients.
Materials and methods
Embase, Medline, Cochrane database, and conference abstracts were searched using the prespecified PICOS criteria from January 2000 to November 2017 for studies reporting HRQoL and patient preference utilities in NIC AML. Studies on patients with RAEB-t MDS, randomized clinical trials (RCTs), prospective observational studies, and patient surveys were included, while systematic reviews and meta-analyses were used for bibliographic searching.
Results
Thirteen records from 12 original studies were identified. These included five records from four RCTs, three prospective studies, four patient survey studies, and one cost-effectiveness analysis. At baseline, NIC AML patients had poor HRQoL scores especially in fatigue (33) and GHS (50) on a 0–100 scale, with higher scores indicating better health. Low baseline HRQoL scores, especially PF and fatigue (<50) were shown to be significant independent predictors of poor survival. Clinical responders demonstrated meaningful improvements, especially in PF and fatigue, along with other health domains after being treated with NIC agents across several studies.
Conclusion
HRQoL is poor for patients with NIC AML; measures such as fatigue and PF at baseline have been identified as independent prognostic factors for overall survival with several studies showing improvement in both domains with treatment. RCTs should incorporate evaluation of treatment impact on patients’ PF and fatigue as important measures of effectiveness.
Supplementary material
Table S1 Search strategy
Acknowledgments
Parts of this study were previously published in an abstract submitted to the 2018 Congress of the European Hematology Association (https://learningcenter.ehaweb.org/eha/2018/stockholm/215952/anna.forsythe.health.related.quality.of.life.28hrqol29.in.acute.myeloid.leukemia.html). Editorial support was provided by Nazia Merritt at Purple Squirrel Economics. This study was funded by Pfizer.
Author contributions
AF, CSK, and TB made substantial contributions to the conception and design of the study, analyzed and interpreted the data, and critically revised the article. TAS analyzed and interpreted the data and critically revised the article for important content. BA contributed to data interpretation and drafting of the article. All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
TB, TAS, and BA are employees of Pfizer. AF and CSK are the employees of Purple Squirrel Economics who were paid consultants to Pfizer in connection with the conduct of the study and development of this article. The authors report no other conflicts of interest in this work.