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4869 Patient-Versus Physician-Perceptions of Symptoms, Treatment and Management in Chronic Myeloid Leukemia

Program: Oral and Poster Abstracts
Session: 903. Health Services and Quality–Myeloid Malignancies: Poster III
Hematology Disease Topics & Pathways:
Research, Clinical Practice (Health Services and Quality), Clinical Research, real-world evidence
Monday, December 12, 2022, 6:00 PM-8:00 PM

Hong Chen1*, Yan Wen2*, Yun Zeng3*, LiE Lin4*, Xin Du5*, Zhenfang Liu6*, Bihong Sun7*, Hongqian Zhu8*, Huiqing He9*, Xiaotao Wang10*, Waiyi Zou11*, Caifeng Zheng12*, Liling Zheng13*, Jinxiong Huang14*, Liping Pang15*, Jixian Huang16*, Yuming Zhang17*, Haiqing Lin18*, Zelin Liu19*, Wanshou Zhu20*, Xuan Zhou, PhD21*, Qiang Wang1*, Xiaoli Liu1*, Qifa Liu22 and Na Xu, MD, PhD1*

1Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
2Department of Hematology, Yunnan Hematology Hospital, First People’ Hospital of Yunnan, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
3Department of Hematology,Yunnan Hematology Research Center, First Affiliated Hospital of Kunming Medical University, Kunming, China
4Department of Hematology, Hainan Provincial People’s Hospital, Haikou 570311, China, Haikou, China
5Department of Hematology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, CA, China
6Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
7Department of Hematology, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
8Department of Hematology , Guizhou Provincial People 's Hospital, Guiyang, China
9Department of Hematology, Zhongshan City People’s Hospital, Zhongshan 528403, China, Zhongshan, China
10Department of Hematology, Guilin medical University affiliated Hospital, Guilin, China
11Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
12Department of Hematology, Shenzhen Bao An People’s Hospital, Shenzhen, China
13Department of Hematology, Guangdong Second Provincial General Hospital, Guangzhou, China
14Department of Hematology, Liuzhou Municipal People’s Hospital, Liuzhou, China
15Department of Hematology, Peking university Shenzhen Hospital, Shenzhen, China
16Department of Hematology, Yue Bei people’s Hospital, Shantou University Medical College, Shaoguan, China
17Department of Hematology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
18Department of Hematology, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
19Department of Hematology, Shenzhen Sixth People's Hospital (Nanshan Hospital), Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518052, China, Shenzhen, China
20Gaozhou People's Hospital, Gaozhou, China
21Department of Hematology,Nanfang Hospital,Southern Medical University, Guangzhou, China
22Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, AL, China

Background Chronic myeloid leukemia (CML) is a chronic disease with treatment-free remission (TFR) increasingly regarded as a feasible goal of treatment. The optimal outcome achieved in CML requires both prolonged adherence to oral tyrosine kinase inhibitor (TKI) therapy by patients and careful monitoring of treatment responses by their physicians. Various factors would impact doctors following international guidelines for CML management in real-word, however, very few studies has investigated possible discrepancies between patient- and physician-reporting in the CML setting.

Objective To compare the reporting of care between CML patients and their treating doctors, and to explore the underlying causes for both physicians and patients non-adherence.

Methods Parallel patient and physician online surveys were conducted between September 22, 2021 and March 15, 2022, using the WeChat-based survey program Wenjuanxing. Descriptive analysis of the results mainly focused on CML adults patients and physicians treating CML regarding TKI treatment options, monitoring and toxicities, TFR, and facing challenges.

Results A total of 1882 patients and 305 physicians completed the survey. Among the enrolled patients, 69.9% received imatinib as first-line therapy, of them 47.0% switched to other TKIs due to imatinib resistance/intolerance (58.5%), exploration on more potent TKI to achieve TFR (13.1%), and treating physicians’ recommendation (15.8%). 91.8% of the physicians believed BCR-ABL1 level should be assessed every 3 months, however, only 42.7% patient respondents committed to 3-monthly testing and 17.8% strictly followed their treating physicians’ recommendation. Half of the patients (49.9%) aimed at TFR, however, just 45.2% physicians considered TFR as one of the three major treatment objectives, obstacles to achieve TFR mainly attributed to their patients. Fatigue and anemia were the key negative impactors for patients who were significantly associated with higher incidence of mental disorders, whilst physicians paid more attention to platelet and neutrophil count. Incidence of moderate to severe anxiety or depression is 12.0% and 20.8%, respectively; but only 41.3% of patients needed support from their doctors, and 53.7% physicians provided their patients with additional support. 13.7% patients had delayed follow-up visit and molecular monitoring, 7.4% patients discontinued TKI or reduced TKI dose due to economic difficulties (69.2%), which resulted in 10.2% patients suffering from disease progression amid the COVID-19 pandemic. 42.3% patients were vaccinated for SARS-CoV-2, another 57.7% patients against vaccine because of safety concern. Cost is the major impactor for treatment choices, molecular monitoring, treatment objective, mental health, and even the treatment under the pandemic, which were fully recognized by both the patients and physicians.

Conclusions Physicians who joined our survey had low awareness on patients’ fatigue and anemia. Mental disorders existed in a significant proportion of patients, whereas less concerned by both patients and physicians. Cost is the major impactor for physician and patient adherence to current clinical practice guidelines, especially under current COVID-19 pandemic in China.

Disclosures: Xu: Suzhou Zelgen Biopharmaceuticals Co.,Ltd.: Honoraria.

*signifies non-member of ASH