TKI-Related Adverse Events Negatively Impact Quality of Life Among Patients With CML

Key Takeaways:

• In a survey cataloguing experiences of patients with chronic myeloid leukemia in chronic phase (CML-CP) receiving tyrosine kinase inhibitors (TKIs), approximately three-fourths reported at least 1 adverse event (AE) in the 7 days prior to survey completion.
• Patients with CML had lower Global Physical Health (GPH) and Global Mental Health (GMH) T-scores than the general US population, and these scores were further impacted by the presence of AEs.
• Work productivity was significantly impaired due to CML, with 53.5% of employed participants changing their employment status.

While TKIs prolong overall survival for patients with CML, they can cause AEs that may negatively impact quality of life. Furthermore, treatment-related AEs can result in interrupted adherence and dose modifications, which may impair disease management.

Researchers conducted the CML Survey on Humanistic Burden of Intolerance to First or Second TKIs to evaluate patient-reported health outcomes and productivity. Patients with CML receiving first- or second-line TKIs were eligible to participate. The survey assessed TKI-related AEs, health-related quality of life, work productivity, and activity impairment in the 7 days prior to survey completion.

A total of 271 patients with CML-CP completed the survey. Among participants, 59.8% received first-line treatments and 40.2% received second-line treatments.

AEs and Quality of Life

Participants reported a median of 3 AEs, with 76.4% experiencing at least 1 AE in the 7 days prior to survey completion. Chronic AEs were reported by 60.9% of participants.

The most common AEs were fatigue (53.9%), pain (44.3%), and gastrointestinal issues (36.9%). Cognitive and mental health AEs were reported by 27.7% and 25.8% of participants, respectively.

Participants had lower GPH and GMH T-scores than the US general population average of 50, with scores of 42.6 and 44.4, respectively. Additionally, 57.9% of participants reported fair-to-poor GPH, and 37.3% reported fair-to-poor GMH.

In linear regression models, participants who experienced at least 1 AE in the 7 days prior to survey completion had lower GPH and GMH T-scores than those without AEs. Each additional chronic AE reduced scores by 1.3 points.

Work Productivity

Across all participants (including those not employed), 37.3% reported activity impairment due to CML.

Over half the participants (53.5%) had to change their employment status due to CML, with 14.0% switching from full-time to part-time, 12.5% going from full-time to unemployed, 10.3% retiring early, and 7.0% taking temporary leave.

Absenteeism due to CML among employed participants was 9.8%. Among those who worked in the past 7 days, 80.0% reported overall work impairment, with 32.7% reporting work productivity loss and 29.0% reporting presenteeism.

In linear regression models, participants who experienced at least 1 AE in the 7 days prior to survey completion had significantly worse activity impairment compared to those without AEs. Each additional chronic AE increased activity impairment by 4.5 percentage points.

Implications for Managed Care

These findings illustrate the substantial burden of TKI therapies experienced among patients with CML, affecting health outcomes, quality of life, and work productivity.

TKI-related AEs were associated with worse physical and mental health compared to the general population as well as significant impairments in work productivity and daily activity.

Interventions aimed at reducing treatment toxicity and improving tolerability may help improve quality of life among patients with CML.

According to the authors, “These results reinforce the importance of comprehensive disease management strategies that address both survival and patients’ ability to maintain daily activity and workforce participation.”

Reference

Schoenbeck K, Wei D, Hazra NC et al. Adverse events, quality of life, and work impairment in patients with chronic myeloid leukemia (CML)—a survey of first- and second-line tyrosine kinase inhibitor (TKI) intolerance in the US. Leukemia Lymphoma. 2026. doi:10.1080/10428194.2026.2721033