Patients’ perceptions about diagnosis and treatment of chronic myeloid leukemia

a cross-sectional study among Brazilian patients

Authors

  • Nelson Hamerschlak Hospital Israelita Albert Einstein (HIAE) and Associação Brasileira de Linfoma e Leucemia
  • Carmino de Souza Universidade Estadual de Campinas and Associação Brasileira de Linfoma e Leucemia
  • Ana Lúcia Cornacchioni Instituto de Tratamento do Câncer Infantil, Instituto da Criança, Hospital de Clínicas da Universidade de São Paulo (HC-USP) and Associação Brasileira de Linfoma e Leucemia
  • Ricardo Pasquini niversidade Federal do Paraná and Associação Brasileira de Linfoma e Leucemia
  • Daniel Tabak Centro de Tratamento Oncológico and Associação Brasileira de Linfoma e Leucemia
  • Nelson Spector Universidade Federal do Rio de Janeiro (UFRJ) Associação Brasileira de Linfoma e Leucemia (ABRALE)
  • Merula Steagall Associação Brasileira de Linfoma e Leucemia

Keywords:

Leukemia, myelogenous, chronic, BCR-ABL positive, Leukemia, myeloid, chronic-phase, Protein-tyrosine kinases, National health programs, Perception, Patient compliance

Abstract

CONTEXT AND OBJECTIVES: Chronic myeloid leukemia (CML) requires strict daily compliance with oral medication and regular blood and bone marrow control tests. The objective was to evaluate CML pa-tients’ perceptions about the disease, their access to information regarding the diagnosis, monitoring and treatment, adverse effects and associations of these variables with patients’ demographics, region and healthcare access. DESIGN AND SETTING: Prospective cross-sectional study among CML patients registered with the Brazil-ian Lymphoma and Leukemia Association (ABRALE). METHODS: CML patients receiving treatment through the public healthcare system were interviewed by telephone. RESULTS: Among 1,102 patients interviewed, the symptoms most frequently leading them to seek medical care were weakness or fatigue. One third were diagnosed by means of routine tests. The time that elapsed between first symptoms and seeking medical care was 42.28 ± 154.21 days. Most patients had been tested at least once for Philadelphia chromosome, but 43.2% did not know the results. 64.8% had had polymerase chain reaction testing for the BCR/ABL gene every three months. 47% believed that CML could be controlled, but 33.1% believed that there was no treatment. About 24% reported occasionally stopping their medication. Imatinib was associated with nausea, cramps and muscle pain. Self-reported treatment adherence was signifi-cantly associated with normalized blood count, and positively associated with imatinib. CONCLUSIONS: There is a lack of information or understanding about disease monitoring tools among Brazilian CML patients; they are diagnosed quickly and have good access to treatment. Correct compre-hension of CML control tools is impaired in Brazilian patients.

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Author Biographies

Nelson Hamerschlak, Hospital Israelita Albert Einstein (HIAE) and Associação Brasileira de Linfoma e Leucemia

MD, PhD. Head of Bone Marrow Transplantation Unit, Hospital Israelita Albert Einstein (HIAE) and Associação Brasileira de Linfoma e Leucemia (ABRALE), São Paulo, Brazil

Carmino de Souza, Universidade Estadual de Campinas and Associação Brasileira de Linfoma e Leucemia

MD, PhD. Titular Professor of Internal Medicine, Universidade Estadual de Campinas (Unicamp), Campinas and Associação Brasileira de Linfoma e Leucemia (ABRALE), São Paulo, Brazil.

Ana Lúcia Cornacchioni, Instituto de Tratamento do Câncer Infantil, Instituto da Criança, Hospital de Clínicas da Universidade de São Paulo (HC-USP) and Associação Brasileira de Linfoma e Leucemia

MD. Attending Physician, Instituto de Tratamento do Câncer Infantil (ITACI), Instituto da Criança (ICR), Hospital de Clínicas da Universidade de São Paulo (HC-USP) and Associação Brasileira de Linfoma e Leucemia (ABRALE), São Paulo, Brazil.

Ricardo Pasquini, niversidade Federal do Paraná and Associação Brasileira de Linfoma e Leucemia

MD, PhD. Senior Professor, Postgraduate Program on Internal Medicine, Universidade Federal do Paraná (UFP), Paraná and Associação Brasileira de Linfoma e Leucemia (ABRALE), São Paulo, Brazil.

Daniel Tabak, Centro de Tratamento Oncológico and Associação Brasileira de Linfoma e Leucemia

MD, PhD. Director, Centro de Tratamento Oncológico (Centron), São Paulo and Associação Brasileira de Linfoma e Leucemia (ABRALE), São Paulo, Brazil.

Nelson Spector, Universidade Federal do Rio de Janeiro (UFRJ) Associação Brasileira de Linfoma e Leucemia (ABRALE)

MD, PhD. Titular Professor, Universidade Federal do Rio de Janeiro (UFRJ), and Head of the Hematology Service, Hospital Universitário Clementino Fraga Filho (HUCCFF), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro; and Associação Brasileira de Linfoma e Leucemia (ABRALE), São Paulo, Brazil.

Merula Steagall, Associação Brasileira de Linfoma e Leucemia

President, Associação Brasileira de Linfoma e Leucemia (ABRALE), São Paulo, Brazil.

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Published

2015-11-11

How to Cite

1.
Hamerschlak N, Souza C de, Cornacchioni AL, Pasquini R, Tabak D, Spector N, Steagall M. Patients’ perceptions about diagnosis and treatment of chronic myeloid leukemia: a cross-sectional study among Brazilian patients. Sao Paulo Med J [Internet]. 2015 Nov. 11 [cited 2025 Mar. 9];133(6):471-9. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1681

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