Kateřina Skřivanová

The effect of imatinib treatment duration on the quality of the life of patients with chronic myeloid leukemia

Purpose: The objective of this study was to evaluate the quality of life (QL) as well as the frequency and severity of depression in patients with chronic phase chronic myeloid leukemia (CP-CML) in relation to the duration of Imatinib treatment. Methods: A detailed analysis of 56 adult patients with CP CML divided into groups according to the length of Imatinib treatment was performed as follows: Group A (n=28)- patients treated for 15 months (median); and Group B (n=28)-patients treated for 50 months (median). All used questionnaires EORTC QLQ-C30 (version 2), SF 36 and BDI were localized and validated. Results: The results from the QL questionnaires found a trend in the improvement in the QL of patients treated with Imatinib for 50 months (median) compared to patients treated for 15 months (median) only. However, a statistically significant improvement in the QL of patients with longer Imatinib treatment was found only in patients without co-existing invalidity and/or rheumatic disease. Moreover, these two comorbidities increased the level of depressive symptoms in patients with CML during the early period of Imatinib therapy. Conclusion: We found a trend in the improvement in the QL of patients with CML in relation to the duration of Imatinib therapy. Statistically significant improvement in the QL of patients with longer Imatinib treatment was found in patients without co-existing invalidity and/or rheumatic disease only.

Predicting Vitality Change in Older Breast Cancer Survivors after Primary Treatment--an Approach Based on Using Time-related Difference of Pro-inflammatory Marker C-reactive Protein.

BACKROUND We aimed to determine prognosis of vitality change and functional status of breast cancer survivors after primary oncological treatment using time-related differences of elevated levels of highly sensitive proinflammatory C-reactive protein (CRP). PATIENTS AND METHODS The test group consisted of 46 elderly breast cancer survivors (median age was 65 years) who completed Vitality Scale of Short Form 36 (SF-36) after completing treatment and another retrospectively at diagnosis. Data on tumor-related factors, treatment, and outcomes were obtained retrospectively from medical records, and linear regression analysis was performed. CRP was followed at diagnosis and one year after primary treatment. Within the scope of this study, clinically important difference in the Vitality Scale was set at five points of change. RESULTS Results showed a statistically significant relationship between CRP change and vitality component of SF-36 change (rs = - 0.350, p = 0.023) in which a decrease in CRP inversely correlated with the quality of life component. The overall change was 1.078 of the vitality scale score (approximately 1 point) for each 1 unit decrease of CRP (1 mg/ L). Association of CRP levels (before and after treatment, its difference between these time points) with age, number of comorbidities and stage of the disease was analyzed and no statistically significant relationship was found in our study. CONCLUSION Preliminary results suggested time-related differences in elevated CRP levels as a potentially suitable predictor for change in vitality status for long term, chronic condition for older breast cancer survivors. We suggest the interpretation schema including an understanding that CRP change of 5 mg/ L and more should be considered a potential risk factor for subsequent negative clinical outcomes.