■急性白血病是白细胞的一种癌症,其进展迅速且剧烈。有两种类型:急性淋巴细胞白血病(ALL)和急性髓细胞性白血病(AML)。后者具有罕见的亚型:急性早幼粒细胞白血病(APL)。对一些病人来说,一线治疗后,没有达到缓解(“难治性疾病”),对其他人来说,白血病在达到缓解后复发(“复发”)。对于这些人来说,结果通常很差。是的,因此,在这种情况下,了解患者的治疗重点很重要。
■建立在形成性定性研究的基础上,我们设计了一项包含离散选择实验(DCE)的在线调查,以探索患者在复发/难治情况下的治疗偏好.DCE属性是给药方式;治疗期间的生活质量;应答机会;应答持续时间;和应答期间的生活质量。每个受访者完成了包含两个假设治疗的十二个方案。如果参与者居住在英国并被诊断为急性白血病,则他们符合资格。使用潜在类模型对数据进行了分析。
■共有95名患者完成了调查。潜在的类分析确定了两个类。对于两者来说,响应的机会是最重要的属性。对于1级,每个属性都很重要,而对于2类,唯一重要的属性是生活质量(治疗和应答期间)和应答机会.总体来说,更大比例的受访者将属于第一类,患有ALL或APL的人以及最近被诊断出的人更有可能处于2级。
■我们的结果表明,患者强烈关注反应的机会,以及生活质量(在较小程度上),当在复发/难治性环境中面临不同的治疗选择时。然而,患者群体内存在显著的偏好异质性,和其他治疗特征对许多人也很重要。
UNASSIGNED: Acute leukemia is a cancer of the white blood cells which progresses rapidly and aggressively. There are two types: acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). The latter has a rare subtype: acute promyelocytic leukemia (APL). For some patients, following first-line treatment, remission is not achieved (\"refractory disease\"), and for others the leukemia returns after achieving remission (\"relapse\"). For these individuals, outcomes are typically poor. It is, therefore, important to understand patients\' treatment priorities in this context.
UNASSIGNED: Building upon formative qualitative research, an online survey containing a discrete choice experiment (DCE) was designed to explore patients\' treatment preferences in the relapsed/refractory setting. The DCE attributes were mode of administration; quality of life during treatment; chance of response; duration of response; and quality of life during response. Each respondent completed twelve scenarios containing two hypothetical treatments. Participants were eligible if they lived in the United Kingdom and had a diagnosis of acute leukemia. The data were analysed using a latent class model.
UNASSIGNED: A total of 95 patients completed the survey. The latent class analysis identified two classes. For both, chance of response was the most important attribute. For class 1, every attribute was important, whereas for class 2, the only important attributes were quality of life (during treatment and response) and chance of response. A greater proportion of respondents would fall into class 1 overall, and those with ALL or APL and those more recently diagnosed were more likely to be in class 2.
UNASSIGNED: Our results indicate that patients are strongly concerned about the chance of response, as well as quality of life (to a lesser extent), when faced with different treatment options in the relapsed/refractory setting. However, there is significant preference heterogeneity within the patient population, and other treatment characteristics also matter to many.