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Abstract
Objectives We aimed to investigate the association between financial toxicity (FT) and the health-related quality of life profile of long-term survivors of acute promyelocytic leukaemia (APL) treated within a universal healthcare system.
Methods We evaluated FT using the financial difficulties item of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). We also compared the prevalence of clinically important problems and symptoms between the survivors of APL with or without FT, using evidence-based thresholds for the EORTC QLQ-C30. A multivariable logistic regression analysis was performed to explore potential risk factors associated with FT.
Results Overall, 352 long-term survivors of APL, with a median age of 53.9 years and a median time since diagnosis of 12.2 years, were analysed. Of these, 71 (20.2%) reported having FT. The prevalence of clinically important problems and symptoms was generally higher across most EORTC QLQ-C30 scales for those survivors who reported FT. The three largest differences between patients with and without FT were observed for emotional functioning (+35.4 percentage points), dyspnoea (+33.1 percentage points) and physical functioning (+27.0 percentage points). The presence of FT was independently associated with having comorbidities and not receiving a salary/pension.
Conclusions These findings suggest that even many years after being diagnosed, one-fifth of long-term survivors of APL experience FT. Interventions to assist with employment may be critical to minimise the risk of FT in the most vulnerable survivors.
- Leukaemia
- Quality of life
- Survivorship
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Footnotes
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Contributors Conception and design: FS and FE. Data analysis and interpretation: all authors. Writing original draft: FS and FE. Final approval of manuscript: all authors. Accountable for all aspects of the work: all authors.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests AV: research funding from Jazz Pharmaceuticals; consultancy for Amgen, Servier, AstraZeneca, Pfizer, Kyte-Gilead, Abbvie, Janssen, Astellas, Astex, Otzuka, Stemline Menarini, BMS, Glycostem, Novartis and Delbert; all outside the submitted work. MV: Honoraria from Amgen, Incyte, Novartis, Dephaforum Srl, Abbvie and Astrazeneca; advisory board for Amgen; all outside the submitted work. FE: consultancy or advisory role for AbbVie, Incyte, Syros, Novartis and JAZZ Pharmaceuticals; all outside the submitted work.
Provenance and peer review Not commissioned; internally peer reviewed.
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