For sufferers with acute leukemia, an important think about selecting a remedy within the relapsed or refractory setting is the prospect of a response, in accordance with a brand new research.
Nonetheless, authors additionally mentioned they discovered a broad vary of opinions amongst sufferers, with some caring about many various elements, and others targeted narrowly on likelihood of response and high quality of life. The research was printed within the journal Affected person Desire and Adherence.1
Sufferers with relapsed or refractory acute leukemia are inclined to have poor outcomes, famous the research authors. For sufferers with each acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL), about half of sufferers who obtain remission on first-line remedy will go on to expertise a relapse. Within the relapse setting, therapeutic choices are usually much less efficient, they added.
Nonetheless, they mentioned a number of research analyzing affected person therapeutic preferences have been printed however that gaps within the scientific literature stay.
“For instance, no research have targeted on the broader inhabitants of individuals with acute leukemia (ie, incorporating every type), which might allow a greater understanding of how preferences differ by (sub) sort,” they wrote. “Moreover, no research have targeted particularly on the relapsed/refractory setting, the place outcomes are usually poorer and preferences could subsequently differ considerably.”
5 attributes of remedy had been evaluated on this survey: mode of administration, high quality of life throughout remedy, likelihood of response, period of response, and high quality of life throughout response | Picture Credit score: Tierney-stock.adobe.com
Within the new research, the investigators created an internet discrete selection survey looking for sufferers’ views on 5 attributes of remedy: mode of administration, high quality of life throughout remedy, likelihood of response, period of response, and high quality of life throughout response. The survey was made up of 12 situations wherein sufferers had to decide on between 2 hypothetical remedy choices.
A complete of 95 sufferers with acute leukemia accomplished the survey. Most (61 sufferers) had AML, and two-thirds (66 sufferers) had achieved remission and had not skilled a relapse. The imply age of the respondents was 53 years.
The investigators mentioned the respondents usually broke down into 2 teams. The primary group accounted for 60% of respondents; on this group, all the attributes reached a stage of statistical significance, that means these sufferers cared about all kinds of things when making remedy selections. Sufferers on this group additionally had been extra more likely to have AML and to have a larger period of time between their preliminary prognosis and the time they accomplished the survey.
Within the second group, which included 40% of respondents, the one attributes of remedy that had been statistically vital had been high quality of life throughout remedy and response, and the prospect of a response. The authors mentioned sufferers with ALL or acute promyelocytic leukemia had been extra more likely to be within the second group.
Total, the investigators mentioned, the outcomes present that remedy choices with a larger likelihood of response can be most valued within the setting of relapsed or refractory illness.
The findings are largely much like a 2021 research of greater than 800 sufferers with AML within the US.2 This research discovered threat of dying and the chance of long-term averse results to be an important priorities for sufferers. Nonetheless, this research additionally differed in that it was restricted to sufferers with AML and it used a best-worst scaling instrument.
Mott and colleagues famous that the respondents of their new research got here totally by recruitment by a affected person advocacy group, they usually mentioned it could be that individuals who search assist from a affected person advocacy group have completely different priorities from the overall affected person inhabitants. In addition they cautioned that their pattern measurement was small. They mentioned future research might consider whether or not there are variations in affected person preferences throughout completely different international locations and remedy settings. One other space value investigating, they mentioned, is how these preferences translate in emotions about particular remedy choices.
References
1. Mott DJ, Hitch J, Nier S, Pemberton-Whiteley Z, Skedgel C. Affected person preferences for remedy in relapsed/refractory acute leukemia in the UK: a discrete selection experiment. Affected person Choose Adherence. 2024;18:1243-1255. Printed 2024 Jun 17. doi:10.2147/PPA.S442530
2. Richardson DR, Oakes AH, Crossnohere NL, et al. Prioritizing the concerns of AML sufferers: Quantifying affected person expertise utilizing best-worst scaling. Psychooncology. 2021;30(7):1104-1111. doi:10.1002/pon.5652
