Health-Related Quality of Life and Financial Burden in Ethiopian Patients With Chronic Myeloid Leukemia Receiving Tyrosine Kinase Inhibitors: A Cross-Sectional Study

Abstract

PURPOSE Health-related quality of life (HRQoL) is now an important goal of therapy for patients with chronic myeloid leukemia (CML). However, there is paucity of data for patients living in low-income countries (LICs) and on factors associated with their HRQoL profile. The primary objective was to compare the HRQoL of patients with CML living in an LIC (Ethiopia) with that of patients living in a high-income country (HIC). METHODS Adult patients with CML treated with tyrosine kinase inhibitors in Ethiopia were considered eligible for this study. To assess their HRQoL and symptom burden, eligible patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the EORTC Quality of Life Questionnaire Chronic Myeloid Leukemia 24 (QLQ-CML24). A matched case-control analysis was applied to compare the HRQoL profile of the herein-recruited Ethiopian cohort with a sample of patients with CML from an HIC (Italy). RESULTS Overall, 395 Ethiopian patients were enrolled between February 2021 and June 2021. Except for dyspnea and satisfaction with care, the Ethiopian patients reported lower HRQoL and functioning and higher symptom burden compared with patients with CML living in an HIC. A remarkable proportion of Ethiopian patients (n = 353, 89.4%) reported financial toxicity (FT). Compared with patients without FT, those with FT reported a higher prevalence of clinically important problems and symptoms across all the QLQ-C30 scales. For example, the prevalence of clinically important impairment of social functioning was almost sixfold higher for patients with FT compared with those without FT (41.8%, 7.1%, respectively). CONCLUSION Our results indicate that the HRQoL profile of patients with CML living in Ethiopia may be worse across several important functional and symptom domains than that of their peers living in an HIC. In addition, FT is highly prevalent among these patients and it is associated with poorer HRQoL outcomes.