摘要
目的探讨慢性粒细胞性白血病(CML)患者对酪氨酸激酶抑制剂(TKI)的依从性及与临床结局的关系。方法选取2020年1月至2023年6月安徽医科大学附属宿州医院收治的80例CML患者,采用中文版莫里斯基用药依从性量表(MMAS⁃8)评估患者的TKI依从性。根据评估结果将患者分为高依从性组和低依从性组,采用多因素Cox比例风险模型分析两组患者依从性相关因素,并比较两组TKI更换率、主要分子反应(MMR)响应率、无进展生存期、生活质量评分。结果Cox回归模型多因素分析结果显示,男性、年龄<70岁、高收入及维持前线TKI治疗的患者依从性更高,且患者的临床结局显示出更明显的改善(P<0.05)。高依从性组的TKI更换率显著低于低依从性组,差异有统计学意义(P<0.05)。高依从性组的TKI更换率显著低于低依从性组,差异有统计学意义(P<0.05)。高依从性组的MMR响应率显著高于低依从性组,差异有统计学意义(P<0.05)。Kaplan⁃Meier生存分析结果显示,高依从性组(62.35±12.39)无进展生存期显著高于低依从性组患者(39.04±10.07),差异有统计学意义(P<0.05)。高依从性患者的生活质量评分显著高于低依从性患者,差异有统计学意义(P<0.05)。结论高依从性CML患者的临床疗效显著更好,临床上应加强干预措施以提高患者的TKI依从性,从而改善患者的预后。
Objective To explore the correlation between adherence to tyrosine kinase inhibitors(TKIs)and clinical outcomes in patients with chronic myeloid leukemia(CML).Methods A total of 80 CML patients treated at Suzhou Hospital Affiliated with Anhui Medical University from January 2020 to June 2023 were selected for this study.The Chinese version of the Morisky Medication Adherence Scale(MMAS⁃8)was used to assess the patients'adherence to TKI therapy.Based on the assessment results,the patients were divided into a high adherence group and a low adherence group.A multivariate Cox proportional hazards model was employed to analyze factors related to adherence in the two groups.Additionally,TKI switching rates,major molecular response(MMR)rates,progression⁃free survival(PFS),and quality of life scores were compared between the two groups.Results The multivariate analysis using the Cox regression model in⁃dicated that male patients,those younger than 70 years old,those with high income,and those who main⁃tained frontline TKI therapy had higher adherence,which was associated with significantly improved clinical outcomes(P<0.05).The TKI switching rate in the high adherence group was significantly lower than that in the low adherence group,with a statistically significant difference(P<0.05).The MMR response rate in the high adherence group was significantly higher than that in the low adherence group,also showing a statistically significant difference(P<0.05).Kaplan⁃Meier survival analysis revealed that the progression⁃free survival in the high adherence group(62.35±12.39)was significantly longer than that in the low adherence group(39.04±10.07),with a statistically significant difference(P<0.05).Furthermore,the quality of life scores in the high adherence group were significantly higher than those in the low adherence group,with a statistically significant difference(P<0.05).Conclusion CML patients with high adherence to TKI therapy exhibit significantly bet⁃ter clinical outcomes.Therefore,clinical interventio
作者
李婉
徐晓坤
赵会英
马圣宇
朱凯
LI Wan;XU Xiaokun;ZHAO Huiying;MA Shengyu;ZHU Kai(Hematology Department,Anhui Medical University Affiliated Suzhou Hospital(Suzhou Municipal Hospi-tal,Anhui Province)Suzhou,Anhui,China,234000;Bengbu Medical College,Bengbu,Anhui,China,233030)
出处
《分子诊断与治疗杂志》
2024年第8期1441-1444,1453,共5页
Journal of Molecular Diagnostics and Therapy
基金
安徽省高等学校科学研究项目(自然科学类)(2023AH052004)。
关键词
慢性粒细胞性白血病
酪氨酸激酶抑制剂
疗效评估
生存率
Chronic myelogenous leukemia
Tyrosine kinase inhibitors
Efficacy Evaluation
Survival Rate
