{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:29:23Z","timestamp":1788262163895,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Treatment\u2010free remission (TFR) has become the main target for chronic myeloid leukemia (CML). Tyrosine kinase inhibitors (TKI) dose optimization is crucial in managing adverse events, and improving adherence in clinical practice. In persons achieving a deep molecular response (DMR), some data suggest TKI dose reduction before discontinuation does not change success rate of achieving TFR, but this is controversial. However, data on quality\u2010of\u2010life (QoL) and mental health in CML patients with full\u2010dose TKI, low\u2010dose TKI, and TKI discontinuation are limited. Moreover, recent evidence indicating the feasibility of TKI dose reduction and discontinuation after dose reduction, which may change CML patients' perspectives on TKI discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cross\u2010sectional study using online questionnaires to explore the QoL, mental health in patients with diverse TKI dose, and perspective on TKI dose reduction as a prelude to discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>1450 responses were included in the analysis. 44.3% of respondents reported a moderate\u2010to\u2010severe impact of TKI treatment on their QoL. 17% of respondents had moderate\u2010to\u2010severe anxiety. 24.4% of respondents had moderate\u2010to\u2010severe depression. In 1326 patients who had not discontinued their medication, 1055 (79.6%) patients reported they would try TKI discontinuation because of concerns over side effects of long\u2010term medication (67.9%), financial burden (68.7%), poor QoL (77.9%), pregnancy needs (11.6%), anxiety and depression while taking TKI (20.8%), inconvenience of TKI treatment (22.2%). 613 of 817 (75.0%) patients on full\u2010dose TKI therapy indicated they preferred trying a dose reduction before discontinuing TKI therapy after dose reduction compared with 31 (3.8%) preferring no dose reduction before stopping.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TKI dose reduction showed a significant improvement of patients' QoL and mental health, comparable to the effect of TKI discontinuation. Most patients indicated they preferred dose reduction before stopping TKI therapy. In clinical practice, TKI dose reduction can be considered as a bridge from full\u2010dose treatment to discontinuation.<\/jats:p><jats:p>Our results showed that tyrosine kinase inhibitors (TKI) dose reduction showed a significant improvement of patients' quality\u2010of\u2010life and mental health, comparable to the effect of TKI discontinuation. Most patients desire to discontinue TKI in the future. TKI discontinuation after dose reduction is more acceptable compared to discontinuing it directly. In clinical practice, TKI dose reduction can be considered as a bridge from full\u2010dose treatment to discontinuation. Please do not hesitate to contact me in case further clarification is needed with this submission.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6296","type":"journal-article","created":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T09:15:24Z","timestamp":1688634924000},"page":"17239-17252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Quality\u2010of\u2010life, mental health, and perspective on <scp>TKI<\/scp> dose reduction as a prelude to discontinuation in chronic phase chronic myeloid leukemia"],"prefix":"10.1002","volume":"12","author":[{"given":"Yilin","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Hematology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Nanfang Hospital 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