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Chen H, Wen Y, Zeng Y, Lin L, Sun B, Zhu H, He H, Wang X, Zou W, Zheng C, Zheng L, Huang J, Pang L, Huang J, Zhang Y, Lin H, Liu Z, Zhu W, Wang Q, Zhou X, Liu X, Qu H, Liu Z, Du X, Xu N. Patient Versus Physician Perspective in the Management of Chronic Myeloid Leukemia During Treatment with Tyrosine Kinase Inhibitors. Oncol Ther 2024; 12:131-145. [PMID: 38104036 PMCID: PMC10881939 DOI: 10.1007/s40487-023-00255-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/21/2023] [Indexed: 12/19/2023] Open
Abstract
INTRODUCTION Chronic myeloid leukemia (CML) is a chronic disease with treatment-free remission (TFR) increasingly regarded as a feasible goal of treatment. However, various factors may influence adherence to international guidelines for CML management. This study aimed to compare the reporting of care between patients with CML and their treating doctors. METHODS Parallel patient and physician online surveys were conducted between September 22, 2021, and March 15, 2022, which focused on the perceptions of 1882 adult patients with CML and 305 physicians regarding tyrosine kinase inhibitor (TKI) treatment options, monitoring and toxicities, TFR, and challenges faced. RESULTS Among the enrolled patients, 69.9% received first-line imatinib treatment, 18.6% received nilotinib, and 4.7% received dasatinib. Among the patients treated with imatinib, 36.7% switched to other TKIs due to imatinib resistance/intolerance (71.1%), exploration of more potent TKIs to achieve TFR (8.9%), and treating physicians' recommendation (14.0%), with a median duration of initial treatment of 14 months [interquartile range (IQR) 6-36]. Most (91.8%) physicians agreed that the breakpoint cluster region-Abelson 1 (BCR::ABL1) transcript level should be assessed every 3 months, but only 42.7% of individuals committed to 3-monthly testing and only 17.8% strictly followed their treating physicians' recommendation. Half of the patients aimed for TFR; however, just 45.2% of physicians considered TFR as one of the top three goals for their patients. The major concern in obtaining TFR was patients' adherence. Fatigue was often distressing for patients with TKIs, while physicians were more concerned about platelet and neutrophil counts. A total of 12% and 20.8% of patients reported moderate/severe anxiety and depression, respectively, while only 53.7% of physicians had concerns about their patients' mental health. During the coronavirus disease 2019 (COVID-19) pandemic, 69.2% of patients reported a reduction in their income. Among these patients, 61.8% maintained their current treatment, while 7.3% switched to cheaper alternatives or discontinued treatment, with over 80% of these patients belonging to the low-income group. CONCLUSIONS Overcoming challenges in patient-physician communication and treatment access is key to improving disease management and quality of life, especially for patients with low income. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT05092048.
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Affiliation(s)
- Hong Chen
- Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Da Dao North, Guangzhou, 510515, Guangdong, China
| | - Yan Wen
- Department of Hematology, Yunnan Hematology Hospital, First People' Hospital of Yunnan, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Yun Zeng
- Department of Hematology, First Affiliated Hospital of Kunming Medical University, Hematology Research Center of Yunnan Province, Kunming, China
| | - Lie Lin
- Department of Hematology, Hainan General Hospital, Haikou, China
| | - Bihong Sun
- Department of Hematology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Hongqian Zhu
- Department of Hematology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Huiqing He
- Department of Hematology, Zhongshan People's Hospital, Zhongshan, China
| | - Xiaotao Wang
- Department of Hematology, Guilin Medical University Affiliated Hospital, Guilin, China
| | - Waiyi Zou
- Department of Hematology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Caifeng Zheng
- Department of Hematology, Shenzhen Bao An People's Hospital, Shenzhen, China
| | - Liling Zheng
- Department of Hematology, The Second People's Hospital of Guangdong Province, Guangzhou, China
| | - Jinxiong Huang
- Department of Hematology, Liuzhou People's Hospital, Liuzhou, China
| | - Liping Pang
- Department of Hematology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Jixian Huang
- Department of Hematology, Yue Bei People's Hospital, Shantou University Medical College, Shaoguan, China
| | - Yuming Zhang
- Department of Hematology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Haiqing Lin
- Department 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
| | - Zelin Liu
- Department of Hematology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Wanshou Zhu
- Department of Hematology, Gaozhou People's Hospital, Gaozhou, China
| | - Qiang Wang
- Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Da Dao North, Guangzhou, 510515, Guangdong, China
| | - Xuan Zhou
- Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Da Dao North, Guangzhou, 510515, Guangdong, China
| | - Xiaoli Liu
- Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Da Dao North, Guangzhou, 510515, Guangdong, China
| | - Hong Qu
- Department of Hematology, Panyu Central Hospital, Guangzhou, China
| | - Zhenfang Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuang Yong Road, Nanning, 530021, Guangxi, China.
| | - Xin Du
- Department of Hematology and Shenzhen Bone Marrow Transplantation Public Service Platform, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen University School of Medicine, 3002 Sungang West Road, Futian District, Shenzhen, 518035, China.
| | - Na Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Da Dao North, Guangzhou, 510515, Guangdong, China.
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Hollenbach L, Rogahn J, le Coutre P, Schulze S, Muegge LO, Geissler J, Gruen J, Junghanss C, Felser S. Physical exercise recommendations for patients with chronic myeloid leukemia based on individual preferences identified in a large international patient survey study of the East German Study Group for Hematology and Oncology (OSHO #97). Front Oncol 2024; 14:1345050. [PMID: 38450192 PMCID: PMC10915004 DOI: 10.3389/fonc.2024.1345050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
Background Tyrosine kinase inhibitors (TKIs) have significantly lowered mortality of chronic myeloid leukemia (CML) patients adjusting life expectancy to that of the standard population. However, CML and its treatment with TKIs causes a high disease burden. Physical exercise (PE) could be a non-pharmacological approach to reducing these and improving quality of life. Purpose The aim of this study was to determine the individual disease burden as well as PE preferences of CML patients and to deduce thereof specific PE recommendations. Methods This multicenter survey was conducted in cooperation with the LeukaNET/Leukemia-patient network including CML patients aged ≥18 years (German Registry of Clinical Trials, DRKS00023698). The severity of selected symptoms was assessed using the adapted Myeloproliferative Neoplasms Symptom Assessment Form: 0 (absent), 1-30 (mild), 31-70 (moderate), or 71-100 (severe). Information about patients' PE needs and preferences depending on their motivation was recorded. Results A total of 212 questionnaires were analyzed (52% female, median age 54 years). The prevalence of moderate-to-severe symptoms was 49% for fatigue, 40% for musculoskeletal pain, and 37% for concentration problems. Other commonly reported symptoms included skin reactions (42%) and weight gain (24%). The proportion of overweight/obese patients was 52%. Half of all respondents requested more information regarding PE. Patients with CML preferred individual training (82%), located outdoors (71%), at home (47%), or in an indoor swimming pool (31%). Regarding the training frequency, sports-inactive patients preferred a frequency of 1-2 training sessions per week, whereas sports-active patients preferred 3-4 sessions per week (p <0.001). Sports-inactive patients preferred a training time of 15-45 minutes, while sports-active patients preferred 30-60 minutes (p = 0.002). Subsequently, PE recommendations were developed for patients with CML. Combined resistance and endurance training (moderate intensity twice per week for 30 minutes) was recommended for beginners. Obese patients should prioritize joint-relieving sports. To reduce the risk of skin reactions, direct sunlight and possibly water sports should be avoided, and UV protection should be used. Conclusion Counseling and motivation of CML patients to be physically active should be part of the standard of care as well as support for implementation.
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Affiliation(s)
- Lina Hollenbach
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Julia Rogahn
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Philipp le Coutre
- Department of Hematology, Oncology, and Cancer Immunology, Campus Virchow‐Klinikum, Charité ‐ Universitätsmedizin Berlin, Berlin, Germany
| | - Susann Schulze
- Krukenberg Cancer Center Halle, University Hospital Halle, Halle (Saale), Germany
- Department of Medicine, Medical Clinic II, Carl-von-Basedow-Klinikum, Merseburg, Germany
| | - Lars-Olof Muegge
- Department of Internal Medicine III, Heinrich Braun Klinikum Zwickau, Zwickau, Germany
| | - Jan Geissler
- LeukaNET/Leukemia-Online e. V., Riemering, Germany
| | - Julia Gruen
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Christian Junghanss
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Sabine Felser
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
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Janssen L, Allard NAE, Aengevaeren VL, Eijsvogels TMH, Timmers S, Blijlevens NMA, Hopman MTE. Exercise-induced release of cardiac and skeletal muscle injury biomarkers in patients with chronic myeloid leukemia receiving TKI therapy. Blood Cancer J 2023; 13:90. [PMID: 37248216 DOI: 10.1038/s41408-023-00861-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/06/2023] [Accepted: 05/17/2023] [Indexed: 05/31/2023] Open
Affiliation(s)
- Lando Janssen
- Radboud Institute for Health Sciences, Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Neeltje A E Allard
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vincent L Aengevaeren
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Silvie Timmers
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Nicole M A Blijlevens
- Radboud Institute for Health Sciences, Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands.
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Graft-Versus-Host Disease: an Update on Functional Implications and Rehabilitation Interventions. Curr Oncol Rep 2023; 25:145-150. [PMID: 36680673 DOI: 10.1007/s11912-023-01363-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW Despite advances in treatment, chronic graft-versus-host disease (cGVHD) remains a highly morbid complication of allogeneic hematopoietic stem cell transplantation. Due to direct effects of the disease on specific body sites, and its treatment, patients lose function. This review summarizes the latest evidence surrounding how cGVHD affects function, and restorative interventions. RECENT FINDINGS Different body sites of cGVHD carry a higher risk of functional decline, including pulmonary and sclerotic/fascial. Support should be comprehensive and individualized, with precautions taken to avoid worsening fibrosis, offloading painful joints and fractures, and utilizing function-directed skilled therapies. Inpatient rehabilitation improves function in hospitalized people with cGVHD. For people with cGVHD, rehabilitation addresses different aspects of impaired function across the spectrum of disease. Given the dynamic nature of the disease process, routine assessment may be warranted. Rehabilitation may also improve deleterious effects of anti-cGVHD medication including glucocorticoids and tyrosine kinase inhibitors.
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Felser S, Rogahn J, le Coutre P, Al-Ali HK, Schulze S, Muegge LO, Gruen J, Geissler J, Kraze-Kliebhahn V, Junghanss C. Anxieties, age and motivation influence physical activity in patients with myeloproliferative neoplasms - a multicenter survey from the East German study group for hematology and oncology (OSHO #97). Front Oncol 2023; 12:1056786. [PMID: 36686756 PMCID: PMC9846799 DOI: 10.3389/fonc.2022.1056786] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
Background Physical activity (PA) is a non-pharmacological approach to alleviate symptom burden and improve health-related quality of life (HrQoL) in cancer patients (pts). Whether pts with myeloproliferative neoplasms (MPN) PA behavior changes due to symptom burden and/or knowledge of the putative beneficial effects of PA has not yet been investigated. Methods We performed a large questionnaire study in MPN pts. Self-reported PA behavior and potential influencing factors of 634 MPN pts were analyzed. Questionnaires were used to assess demographics, anxiety, severity of symptoms, HrQoL, current level of everyday and sports activities, and the level of information regarding the importance/possibilities of PA. According to their PA, the pts were assigned to the three groups: "inactive", "non-targeted active", and "sporty active" and compared with each other. Results Key findings are that in 73% of the pts, the disease had an impact on PA, with 30% of pts reducing their PA. The prevalence of anxieties (e.g., occurrence of thrombosis and bleeding) regarding PA was 45%. Sporty active pts had a lower symptom burden and better HrQoL (p ≤ 0.001) compared to the other groups. Inactive pts were significantly older and had a higher body mass index than sporty active pts. Inactive and non-targeted active pts felt less informed about the importance/possibilities of PA (p = 0.002). Conclusion Our results suggest that especially older and non-sporty MPN pts could benefit from motivational as well as disease-specific PA information. This study was registered at the German Registry of Clinical Trials, DRKS00023698.
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Affiliation(s)
- Sabine Felser
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany,*Correspondence: Sabine Felser,
| | - Julia Rogahn
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Philipp le Coutre
- Department of Hematology, Oncology, and Cancer Immunology, Charité Campus Virchow-Klinikum, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Haifa Kathrin Al-Ali
- Krukenberg Cancer Center Halle, University Hospital Halle, Halle (Saale), Halle, Germany
| | - Susann Schulze
- Krukenberg Cancer Center Halle, University Hospital Halle, Halle (Saale), Halle, Germany,Department of Internal Medicine, Medical Clinic II, Carl-von-Basedow-Klinikum, Merseburg, Germany
| | - Lars-Olof Muegge
- Department of Internal Medicine III, Heinrich Braun Hospital, Zwickau, Germany
| | - Julia Gruen
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Jan Geissler
- LeukaNET/Leukemia Online e.V., Riemerling, Germany
| | | | - Christian Junghanss
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
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Quittmann OJ, Lenatz B, Bartsch P, Lenatz F, Foitschik T, Abel T. Case Report: Training Monitoring and Performance Development of a Triathlete With Spinal Cord Injury and Chronic Myeloid Leukemia During a Paralympic Cycle. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:867089. [PMID: 36188916 PMCID: PMC9487515 DOI: 10.3389/fresc.2022.867089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Abstract
Introduction Paratriathlon allows competition for athletes with various physical impairments. The wheelchair category stands out from other paratriathlon categories, since competing in swimming, handcycling, and wheelchair racing entails substantial demands on the upper extremity. Therefore, knowledge about exercise testing and training is needed to improve performance and avoid overuse injuries. We described the training monitoring and performance development throughout a Paralympic cycle of an elite triathlete with spinal cord injury (SCI) and a recent diagnosis of chronic myeloid leukemia (CML). Case Presentation/Methods A 30-year-old wheelchair athlete with 10-years experience in wheelchair basketball contacted us for guidance regarding testing and training in paratriathlon. Laboratory and field tests were modified from protocols used for testing non-disabled athletes to examine their physical abilities. In handcycling, incremental tests were used to monitor performance development by means of lactate threshold (POBLA) and define heart rate-based training zones. All-out sprint tests were applied to calculate maximal lactate accumulation rate (V˙Lamax) as a measure of glycolytic capabilities in all disciplines. From 2017 to 2020, training was monitored to quantify training load (TL) and training intensity distribution (TID). Results From 2016 to 2019, the athlete was ranked within the top ten at the European and World Championships. From 2017 to 2019, annual TL increased from 414 to 604 h and demonstrated a shift in TID from 77-17-6% to 88-8-4%. In this period, POBLA increased from 101 to 158 W and V˙Lamax decreased from 0.56 to 0.36 mmol·l−1·s−1. TL was highest during training camps. In 2020, after he received his CML diagnosis, TL, TID, and POBLA were 317 h, 94-5-1%, and 108 W, respectively. Discussion TL and TID demonstrated similar values when compared with previous studies in para-swimming and long-distance paratriathlon, respectively. In contrast, relative TL during training camps exceeded those described in the literature and was accompanied by physical stress. Increased volumes at low intensity are assumed to increase POBLA and decrease V˙Lamax over time. CML treatment and side effects drastically decreased TL, intensity, and performance, which ultimately hindered a qualification for Tokyo 2020/21. In conclusion, there is a need for careful training prescription and monitoring in wheelchair triathletes to improve performance and avoid non-functional overreaching.
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Affiliation(s)
- Oliver J. Quittmann
- Department IV: Movement Rehabilitation, Neuromechanics and Paralympic Sport, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
- European Research Group in Disability Sport (ERGiDS), Bonn, Germany
- *Correspondence: Oliver J. Quittmann
| | - Benjamin Lenatz
- Department IV: Movement Rehabilitation, Neuromechanics and Paralympic Sport, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | | | - Frauke Lenatz
- Department IV: Movement Rehabilitation, Neuromechanics and Paralympic Sport, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - Tina Foitschik
- Department IV: Movement Rehabilitation, Neuromechanics and Paralympic Sport, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - Thomas Abel
- Department IV: Movement Rehabilitation, Neuromechanics and Paralympic Sport, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
- European Research Group in Disability Sport (ERGiDS), Bonn, Germany
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Lipton JH, Brümmendorf TH, Gambacorti-Passerini C, Garcia-Gutiérrez V, Deininger MW, Cortes JE. Long-term safety review of tyrosine kinase inhibitors in chronic myeloid leukemia - What to look for when treatment-free remission is not an option. Blood Rev 2022; 56:100968. [DOI: 10.1016/j.blre.2022.100968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022]
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Lu Y, Yuan Z, Chen J, Wang Z, Liu Z, Wu Y, Zhan D, Zhao Q, Pei M, Xie M. A New Tool for Rapid Assessment of Acute Exercise-Induced Fatigue. Front Hum Neurosci 2022; 16:856432. [PMID: 35370582 PMCID: PMC8965889 DOI: 10.3389/fnhum.2022.856432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background There are limited sensitive evaluation methods to distinguish people's symptoms of peripheral fatigue and central fatigue simultaneously. The purpose of this study is to identify and evaluate them after acute exercise with a simple and practical scale. Methods The initial scale was built through a literature review, experts and athlete population survey, and a small sample pre-survey. Randomly selected 1,506 students were evaluated with the initial scale after exercise. Subjective fatigue self-assessments (SFSA) were completed at the same time. Results The Acute Exercise-Induced Fatigue Scale (AEIFS) was determined after performing a factor analysis. In the exploratory factor analysis, the cumulative variance contribution rate was 65.464%. The factor loadings of the total 8 questions were 0.661-0.816. In the confirmatory factor analysis, χ2/df = 2.529, GFI = 0.985, AGFI = 0.967, NFI = 0.982, IFI = 0.989, CFI = 0.989, and RMSEA = 0.048. The Cronbach's alpha coefficient for the scale was 0.872, and it was 0.833 for peripheral fatigue and 0.818 for central fatigue. The intra-class correlation coefficient for the scale was 0.536, and the intra-class correlation coefficients for peripheral fatigue and central fatigue were 0.421 and 0.548, respectively. The correlation coefficient between the total score of the AEIFS and the SFSA score was 0.592 (p < 0.01). Conclusion Our results demonstrate that the AEIFS can distinguish peripheral fatigue and central fatigue and can also reflect their correlation. This scale can be a useful evaluation tool not only for measuring fatigue after acute exercise but also for guiding reasonable exercise, choosing objective testing indicators, and preventing sports injuries resulting from acute exercise-induced fatigue.
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Affiliation(s)
- Yao Lu
- Department of Neurology, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of Clinical Medicine, Capital Medical University, Beijing, China
| | - Ziyang Yuan
- Department of Clinical Medicine, Capital Medical University, Beijing, China
| | - Jiaping Chen
- Department of Neurology, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of Clinical Medicine, Capital Medical University, Beijing, China
| | - Zeyi Wang
- Department of Neurology, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of Clinical Medicine, Capital Medical University, Beijing, China
| | - Zhandong Liu
- Department of Neurology, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yanjue Wu
- Beijing Peirong Biotech Co., Ltd, Beijing, China
| | - Donglin Zhan
- Daxing No.1 Middle School Beijing, Beijing, China
| | - Qingbao Zhao
- Department of Physical Education, Beijing Institute of Petrochemical Technology, Beijing, China
| | - Mofei Pei
- Baoding No.17 Middle School, Baoding, China
| | - Minhao Xie
- China Institute of Sports Medicine, Beijing, China
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Saydam G, Ali R, Demir AM, Eskazan AE, Guvenc B, Haznedaroglu IC, Ozcan MA, Salim O, Sonmez M, Tuglular AT, Turgut M, Unal A, Aver B, Bozkurt S, Ozdengulsun B, Ilhan O. The effect of comorbidities on the choice of tyrosine kinase inhibitors in patients with chronic myeloid leukemia. Int J Hematol Oncol 2022; 11:IJH38. [PMID: 35664044 PMCID: PMC9136639 DOI: 10.2217/ijh-2021-0010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 03/07/2022] [Indexed: 11/23/2022] Open
Abstract
Tyrosine kinase inhibitors (TKIs) approved for chronic myeloid leukemia known to have similar efficacies but different safety profiles. Therefore, the choice of patient-specific treatments is driven by factors such as tolerability and adverse event profile of TKIs. This review article examines the most up-to-date data and provides practical recommendations for clinical approaches. Nilotinib and ponatinib should be avoided in patients with cardiovascular risk factors, dasatinib in patients with lung damage and bosutinib and nilotinib in patients with liver disease. Considering that certain comorbidities predispose some patients to developing severe adverse events when receiving TKIs, the first- and second-line treatment of chronic myeloid leukemia should be tailored to each patient's individual condition.
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Affiliation(s)
- Guray Saydam
- Department of Internal Diseases, Division of Hematology, Ege University Medical Faculty Hospital, İzmir, Turkey,Author for correspondence:
| | - Ridvan Ali
- Department of Internal Diseases, Division of Hematology, Uludag University Medical Faculty Hospital, Bursa, Turkey
| | - Ahmet Muzaffer Demir
- Department of Internal Diseases, Division of Hematology, Trakya University Medical Faculty Hospital, Edirne, Turkey
| | - Ahmet Emre Eskazan
- Department of Internal Diseases, Division of Hematology, Istanbul University Cerrahpaşa Faculty Hospital, İstanbul, Turkey
| | - Birol Guvenc
- Department of Internal Diseases, Division of Hematology, Cukurova University Medical Faculty Hospital, Adana, Turkey
| | | | - Mehmet Ali Ozcan
- Department of Internal Diseases, Division of Hematology, Dokuz Eylul University Medical Faculty Hospital, İzmir, Turkey
| | - Ozan Salim
- Department of Internal Diseases, Division of Hematology, Akdeniz University Medical Faculty Hospital, Antalya, Turkey
| | - Mehmet Sonmez
- Department of Internal Diseases, Division of Hematology, Karadeniz Technical University Medical Faculty Hospital, Trabzon, Turkey
| | - Ayse Tulin Tuglular
- Department of Internal Diseases, Division of Hematology, Marmara University Medical Faculty Hospital, İstanbul, Turkey
| | - Mehmet Turgut
- Department of Internal Diseases, Division of Hematology, Ondokuz Mayıs University Medical Faculty Hospital, Samsun, Turkey
| | - Ali Unal
- Department of Internal Diseases, Division of Hematology, Erciyes University Medical Faculty Hospital, Kayseri, Turkey
| | - Birkan Aver
- Medical Oncology Department, Pfizer Pharmaceuticals, Istanbul, Turkey
| | - Sirac Bozkurt
- Medical Oncology Department, Pfizer Pharmaceuticals, Istanbul, Turkey
| | - Begum Ozdengulsun
- Medical Oncology Department, Pfizer Pharmaceuticals, Istanbul, Turkey
| | - Osman Ilhan
- Department of Internal Diseases, Division of Hematology, Ankara University Medical Faculty Hospital, Ankara, Turkey
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Oswald LB, Hyland KA, Eisel SL, Hoogland AI, Knoop H, Nelson AM, Pinilla-Ibarz J, Sweet K, Jacobsen PB, Jim HS. Correlates of fatigue severity in patients with chronic myeloid leukemia treated with targeted therapy. Support Care Cancer 2022; 30:87-94. [PMID: 34231041 PMCID: PMC8639627 DOI: 10.1007/s00520-021-06408-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/28/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE Tyrosine kinase inhibitors (TKIs) substantially improve survival for patients with chronic myeloid leukemia (CML), but fatigue associated with TKIs can negatively impact patients' quality of life and adherence. This study sought to identify correlates of fatigue (e.g., sociodemographic characteristics, clinical characteristics, health behaviors) among patients with CML taking TKIs who reported moderate to severe fatigue. METHODS Adults with CML experiencing at least moderate fatigue were recruited for a pilot trial of a cognitive behavioral intervention to improve fatigue. Data collected pre-intervention were used to explore concurrent correlates of fatigue in univariate and multivariable models. RESULTS Participants (N = 44, 48% female) were M = 55.6 years old (SD = 12.6) and had been diagnosed with CML M = 5.2 years prior (SD = 5.3). Participants had been taking their current TKI for M = 2.5 years (SD = 2.7). Most participants (64%) had previously been treated with ≥ 1 other TKI. More than three-quarters of participants (77%) reported severe fatigue. In univariate models, worse fatigue was associated with higher BMI (r = -0.36, p = 0.018), prior treatment with other TKI(s) (r = - 0.34, p = 0.024), worse sleep disturbance (r = - 0.51, p < 0.001), and less physical activity (r = 0.31, p = 0.043). In a multivariable model, significant univariate correlates accounted for 39% of the variance in fatigue. Worse fatigue remained significantly correlated with higher BMI (β = - 0.33, p = 0.009) and more disturbed sleep (β = - 0.45, p < 0.001). CONCLUSION Results may inform future research aiming to identify fatigued patients with CML at risk for experiencing more severe fatigue during TKI therapy. Identifying predictors of fatigue severity could aid clinicians in identifying which patients will benefit from referrals to supportive therapy. TRIAL REGISTRATION NCT02592447, October 30, 2015.
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Affiliation(s)
- Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Kelly A. Hyland
- Department of Psychology, University of South Florida, Tampa, FL
| | - Sarah L. Eisel
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam
| | - Ashley M. Nelson
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA
| | | | - Kendra Sweet
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL
| | - Paul B. Jacobsen
- Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, MD
| | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
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de Carvalho AC, Ogawa CY, De Camillis Rodrigues L, de Medeiros LS, Veiga TAM. Penicillium genus as a source for anti-leukemia compounds: an overview from 1984 to 2020. Leuk Lymphoma 2021; 62:2079-2093. [PMID: 33733992 DOI: 10.1080/10428194.2021.1897804] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Penicillium is a widely explored genus due to its chemical diversity and associated biological properties; in addition, it represents an important source for cytotoxic compounds with good application perspectives. Based on these aspects, in this review, Penicillium compounds that presented activity against human leukemia cell lines are being listed and discussed. For this, a careful bibliographic survey was carried out in the main electronic databases, i.e. Scopus, SciFinder, Web of Science and Pubmed. Between 1984 and 2020, thirty seven original papers were selected, when using the search terms Penicillium and leukemia. The occurrence of l-asparaginase produced by some Penicillium spp. was also highlighted since this enzyme is being employed for acute lymphoblastic leukemia and lymphosarcoma therapies. Therefore, this overview aims to demonstrate the potential of metabolites biosynthesized by Penicillium fungi which can be applied in human leukemia therapies and opportunities for designing new lead compounds.
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