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Credit: CDC
Results of population-based research suggest that financial status may affect survival in patients with chronic myeloid leukemia (CML) living in the UK.
The study showed that, despite equal access to the same clinical care and treatment, survival rates were significantly lower for patients living in more deprived areas.
The researchers said this difference might be explained by lower rates of treatment compliance in the less affluent population.
“These findings highlight the importance of conducting comprehensive, population-based studies to examine treatment pathways across the entire patient population, rather than solely concentrating on findings from clinical trials,” said study author Alexandra Smith, PhD, of the University of York in the UK.
She and her colleagues recounted their findings in BMJ Open.
The team analyzed data from 242 patients who were diagnosed with CML from September 2004 to August 2011. Ninety-seven percent of patients had chronic-phase disease at presentation, and 86% were Ph-positive.
Fifty-five percent of patients were younger than 60 at diagnosis, and 60% were male. Fifty-nine percent lived in deprivation quintiles 1 to 3, and 41% lived in the less affluent quintiles 4 and 5.
Ninety-seven percent of patients received treatment with tyrosine kinase inhibitors (TKIs)—94% imatinib and the rest dasatinib. Three percent of patients were not treated with TKIs due to death, relocation, refusal, a more serious competing comorbidity, or the use of supportive care alone.
Factors affecting survival
The minimum follow-up was 1.5 years, and the maximum was 8.5 years. The overall 5-year survival was 79%. And the relative survival, which took into account the background mortality in the general population, was 89%.
The relative survival curves did not differ significantly between the 2 age groups. Five-year relative survival was 90% for patients younger than 60 and 87% for those older than 60.
Gender also had little impact on relative survival. The 5-year rates were 90% for men and 89% for women.
However, relative survival differed significantly according to affluence. The 5-year relative survival was 95% for the most affluent patients (quintiles 1 to 3) and 80% for the least affluent (quintiles 4 and 5).
Although 41% of all patients lived in the less affluent areas, this group accounted for about 60% of the deaths.
The researchers said this finding could not be attributed to biological features of disease or access to therapy. But they believe a lack of treatment compliance could be the cause.
“We suspect a major factor is that we are not supporting patients sufficiently to allow them to be fully compliant with a treatment that needs to be taken every day to be effective,” said Russell Patmore, MD, of Castle Hill Hospital in the UK.
“We would encourage all teams treating patients with CML to use these findings to focus their resource where it is likely to be most beneficial. This includes helping patients to manage their CML by explaining fully the importance of daily treatment and providing easy access to ongoing support.” 
Credit: CDC
Results of population-based research suggest that financial status may affect survival in patients with chronic myeloid leukemia (CML) living in the UK.
The study showed that, despite equal access to the same clinical care and treatment, survival rates were significantly lower for patients living in more deprived areas.
The researchers said this difference might be explained by lower rates of treatment compliance in the less affluent population.
“These findings highlight the importance of conducting comprehensive, population-based studies to examine treatment pathways across the entire patient population, rather than solely concentrating on findings from clinical trials,” said study author Alexandra Smith, PhD, of the University of York in the UK.
She and her colleagues recounted their findings in BMJ Open.
The team analyzed data from 242 patients who were diagnosed with CML from September 2004 to August 2011. Ninety-seven percent of patients had chronic-phase disease at presentation, and 86% were Ph-positive.
Fifty-five percent of patients were younger than 60 at diagnosis, and 60% were male. Fifty-nine percent lived in deprivation quintiles 1 to 3, and 41% lived in the less affluent quintiles 4 and 5.
Ninety-seven percent of patients received treatment with tyrosine kinase inhibitors (TKIs)—94% imatinib and the rest dasatinib. Three percent of patients were not treated with TKIs due to death, relocation, refusal, a more serious competing comorbidity, or the use of supportive care alone.
Factors affecting survival
The minimum follow-up was 1.5 years, and the maximum was 8.5 years. The overall 5-year survival was 79%. And the relative survival, which took into account the background mortality in the general population, was 89%.
The relative survival curves did not differ significantly between the 2 age groups. Five-year relative survival was 90% for patients younger than 60 and 87% for those older than 60.
Gender also had little impact on relative survival. The 5-year rates were 90% for men and 89% for women.
However, relative survival differed significantly according to affluence. The 5-year relative survival was 95% for the most affluent patients (quintiles 1 to 3) and 80% for the least affluent (quintiles 4 and 5).
Although 41% of all patients lived in the less affluent areas, this group accounted for about 60% of the deaths.
The researchers said this finding could not be attributed to biological features of disease or access to therapy. But they believe a lack of treatment compliance could be the cause.
“We suspect a major factor is that we are not supporting patients sufficiently to allow them to be fully compliant with a treatment that needs to be taken every day to be effective,” said Russell Patmore, MD, of Castle Hill Hospital in the UK.
“We would encourage all teams treating patients with CML to use these findings to focus their resource where it is likely to be most beneficial. This includes helping patients to manage their CML by explaining fully the importance of daily treatment and providing easy access to ongoing support.”
Credit: CDC
Results of population-based research suggest that financial status may affect survival in patients with chronic myeloid leukemia (CML) living in the UK.
The study showed that, despite equal access to the same clinical care and treatment, survival rates were significantly lower for patients living in more deprived areas.
The researchers said this difference might be explained by lower rates of treatment compliance in the less affluent population.
“These findings highlight the importance of conducting comprehensive, population-based studies to examine treatment pathways across the entire patient population, rather than solely concentrating on findings from clinical trials,” said study author Alexandra Smith, PhD, of the University of York in the UK.
She and her colleagues recounted their findings in BMJ Open.
The team analyzed data from 242 patients who were diagnosed with CML from September 2004 to August 2011. Ninety-seven percent of patients had chronic-phase disease at presentation, and 86% were Ph-positive.
Fifty-five percent of patients were younger than 60 at diagnosis, and 60% were male. Fifty-nine percent lived in deprivation quintiles 1 to 3, and 41% lived in the less affluent quintiles 4 and 5.
Ninety-seven percent of patients received treatment with tyrosine kinase inhibitors (TKIs)—94% imatinib and the rest dasatinib. Three percent of patients were not treated with TKIs due to death, relocation, refusal, a more serious competing comorbidity, or the use of supportive care alone.
Factors affecting survival
The minimum follow-up was 1.5 years, and the maximum was 8.5 years. The overall 5-year survival was 79%. And the relative survival, which took into account the background mortality in the general population, was 89%.
The relative survival curves did not differ significantly between the 2 age groups. Five-year relative survival was 90% for patients younger than 60 and 87% for those older than 60.
Gender also had little impact on relative survival. The 5-year rates were 90% for men and 89% for women.
However, relative survival differed significantly according to affluence. The 5-year relative survival was 95% for the most affluent patients (quintiles 1 to 3) and 80% for the least affluent (quintiles 4 and 5).
Although 41% of all patients lived in the less affluent areas, this group accounted for about 60% of the deaths.
The researchers said this finding could not be attributed to biological features of disease or access to therapy. But they believe a lack of treatment compliance could be the cause.
“We suspect a major factor is that we are not supporting patients sufficiently to allow them to be fully compliant with a treatment that needs to be taken every day to be effective,” said Russell Patmore, MD, of Castle Hill Hospital in the UK.
“We would encourage all teams treating patients with CML to use these findings to focus their resource where it is likely to be most beneficial. This includes helping patients to manage their CML by explaining fully the importance of daily treatment and providing easy access to ongoing support.”