{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T22:50:03Z","timestamp":1752360603882,"version":"3.40.5"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Chronic Myeloid Leukaemia (CML) responds well with the targeted therapy drugs, Tyrosine Kinase Inhibitors (TKI), that give potentially long-term disease control for the patients. The objective of this study was to determine the disease burden and factors influencing the health-related quality of life (HRQoL) and health status of CML patients in Klang Valley, Malaysia. CML patients were recruited from haematological outpatient clinics in health centres in Klang Valley, Malaysia. A semi-guided self-administered questionnaire was used. HRQoL was measured by EQ-5D utility value and health status was by visual analogue score (VAS). Logistic regression analysis was conducted to determine the factors influencing HRQoL and health status. A total of 221 respondents participated, where more than half were Malay (56.6%), male (53.4%), and an Imatinib user (68.8%). Majority were diagnosed at the chronic phase (89.5%). The mean age of diagnosis was 41 years old. Significant determinant associated with HRQoL was age of diagnosis. These factors had no significant effect on the HRQoL of these patients regardless of types of TKI used and initial phase of CML. The overall HRQoL of CML patients were comparable to, if not higher, than the general population. Any TKI that was good enough to eliminate disease symptoms and erase patient\u2019s worries, can possibly make CML patients have a better quality of life than typical cancer patients and even the general population.<\/jats:p>","DOI":"10.1371\/journal.pone.0256804","type":"journal-article","created":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T17:28:55Z","timestamp":1630085335000},"page":"e0256804","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Health-related quality of life using EQ-5D among chronic myeloid leukaemia patients in health centres in Klang Valley, Malaysia"],"prefix":"10.1371","volume":"16","author":[{"given":"Sharifa Ezat","family":"Wan Puteh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azimatun Noor","family":"Aizuddin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nor Rafeah","family":"Tumian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jameela","family":"Sathar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2399-0193","authenticated-orcid":true,"given":"Ellyana","family":"Mohamad Selamat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,8,27]]},"reference":[{"unstructured":"National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Chronic Myeloid Leukemia V.1.2019. 2018 [Available from: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/cml.pdf.","key":"pone.0256804.ref001"},{"unstructured":"Besa E, Buehler, B., Markman, M., Sacher, R. & Krishnan, K.,. Chronic Myelogenous Leukemia (CML) Treatment & Management 2014 [Available from: https:\/\/emedicine.medscape.com\/article\/199425-treatment.","key":"pone.0256804.ref002"},{"issue":"1","key":"pone.0256804.ref003","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s12185-008-0230-0","article-title":"Chronic myeloid leukemia in Asia","volume":"89","author":"WY Au","year":"2009","journal-title":"International journal of hematology"},{"issue":"11","key":"pone.0256804.ref004","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1016\/j.leukres.2010.03.033","article-title":"Chronic myeloid leukemia in the Asia-Pacific region: current practice, challenges and opportunities in the targeted therapy era.","volume":"34","author":"D-W Kim","year":"2010","journal-title":"Leukemia research."},{"unstructured":"Azizah Ab M NSIT, Noor Hashimah A, Asmah Z.A, Mastulu W,. Malaysian National Cancer Registry Report 2011 [Available from: https:\/\/nci.moh.gov.my\/index.php\/ms\/pengumuman\/340-national-cancer-registry-report.","key":"pone.0256804.ref005"},{"unstructured":"Ong Mei Ching. Malaysia Patient Assistance Program 2011 [Available from: https:\/\/www.cmladvocates.net\/download\/cml-horizons-conferences\/rising-sun-2011\/46-rs-2011-show-and-tell-malaysian-patient-assistance-program-mei-ching\/file.","key":"pone.0256804.ref006"},{"unstructured":"Ministry of Health Malaysia. National Strategic Plan For Cancer Control Programme 2016\u20132020 2017 [Available from: https:\/\/www.iccp-portal.org\/plans\/national-strategic-plan-cancer-control-programme.","key":"pone.0256804.ref007"},{"volume-title":"Effectiveness and cost-effectiveness of imatinib for first-line treatment of chronic myeloid leukaemia in chronic phase: a systematic review and economic analysis","year":"2004","author":"K Dalziel","key":"pone.0256804.ref008"},{"issue":"23","key":"pone.0256804.ref009","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.1056\/NEJMoa062867","article-title":"Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia","volume":"355","author":"BJ Druker","year":"2006","journal-title":"New England Journal of Medicine"},{"issue":"11","key":"pone.0256804.ref010","doi-asserted-by":"crossref","first-page":"2574","DOI":"10.1002\/cncr.20694","article-title":"Cost\u2010effectiveness of imatinib versus interferon\u2010\u03b1 plus low\u2010dose cytarabine for patients with newly diagnosed chronic\u2010phase chronic myeloid leukemia.","volume":"101","author":"SD Reed","year":"2004","journal-title":"Cancer: Interdisciplinary International Journal of the American Cancer Society."},{"key":"pone.0256804.ref011","doi-asserted-by":"crossref","DOI":"10.1155\/2015\/982395","article-title":"Effectiveness and cost-effectiveness of sequential treatment of patients with chronic myeloid leukemia in the United States: a decision analysis.","volume":"2015","author":"U Rochau","year":"2015","journal-title":"Leukemia research and treatment"},{"issue":"7","key":"pone.0256804.ref012","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1200\/JCO.2005.04.6557","article-title":"Pregnancy among patients with chronic myeloid leukemia treated with imatinib","volume":"24","author":"P Ault","year":"2006","journal-title":"Journal of clinical oncology"},{"issue":"3","key":"pone.0256804.ref013","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1176\/appi.neuropsych.12070177","article-title":"Cognitive and other predictors of change in quality of life one year after treatment for chronic myelogenous leukemia or myelodysplastic syndrome","volume":"26","author":"G Chang","year":"2014","journal-title":"The Journal of neuropsychiatry and clinical neurosciences"},{"issue":"2","key":"pone.0256804.ref014","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1007\/s11899-016-0306-5","article-title":"Quality of life and long-term therapy in patients with chronic myeloid leukemia","volume":"11","author":"KE Flynn","year":"2016","journal-title":"Current hematologic malignancy reports"},{"issue":"11","key":"pone.0256804.ref015","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1185\/03007995.2014.944973","article-title":"Impact of low-grade adverse events on health-related quality of life in adult patients receiving imatinib or nilotinib for newly diagnosed Philadelphia chromosome positive chronic myelogenous leukemia in chronic phase","volume":"30","author":"A Gu\u00e9rin","year":"2014","journal-title":"Current medical research and opinion"},{"unstructured":"World Health Organisation. WHOQOL: Measuring Quality of Life 2020 [Available from: https:\/\/www.who.int\/healthinfo\/survey\/whoqol-qualityoflife\/en\/.","key":"pone.0256804.ref016"},{"unstructured":"Office of Disease Prevention and Health Promotion. Health-Related Quality of Life & Well-Being 2014 [Available from: https:\/\/www.healthypeople.gov\/2020\/topics-objectives\/topic\/health-related-quality-of-life-well-being.","key":"pone.0256804.ref017"},{"unstructured":"The Malaysian Reserve. The promise of Klang Valley\u2019s southern expansion 2017 [Available from: https:\/\/themalaysianreserve.com\/2017\/04\/03\/the-promise-of-klang-valleys-southern-expansion\/.","key":"pone.0256804.ref018"},{"issue":"19","key":"pone.0256804.ref019","doi-asserted-by":"crossref","first-page":"3372","DOI":"10.1002\/cncr.29512","article-title":"Are high drug prices for hematologic malignancies justified? A critical analysis","volume":"121","author":"J Chhatwal","year":"2015","journal-title":"Cancer"},{"issue":"3","key":"pone.0256804.ref020","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.healthpol.2013.03.006","article-title":"Do reassessments reduce the uncertainty of decision making? Reviewing reimbursement reports and economic evaluations of three expensive drugs over time.","volume":"112","author":"FG Sandmann","year":"2013","journal-title":"Health policy."},{"unstructured":"Malaysian Medical Resources. Public Hospitals 2020 [Available from: https:\/\/new.medicine.com.my\/government\/hospitals\/name\/hospital-ampang\/.","key":"pone.0256804.ref021"},{"unstructured":"Ampang Hospital. Jabatan Haematologi 2017 [Available from: https:\/\/hampg.moh.gov.my\/index.php\/jabatan\/klinikal\/jabatan-haematologi.","key":"pone.0256804.ref022"},{"unstructured":"Resources MM. Public Hospitals 2020 [Available from: https:\/\/new.medicine.com.my\/government\/hospitals\/?cn-s=WP&Kuala&Lumpur.","key":"pone.0256804.ref023"},{"issue":"3","key":"pone.0256804.ref024","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/0168-8510(90)90421-9","article-title":"EuroQol-a new facility for the measurement of health-related quality of life.","volume":"16","author":"The EuroQol Group","year":"1990","journal-title":"Health policy."},{"key":"pone.0256804.ref025","first-page":"19","volume-title":"The descriptive system of the EuroQOL instrument. EQ-5D concepts and methods: a developmental history","author":"Springer","year":"2005"},{"key":"pone.0256804.ref026","first-page":"45","article-title":"Psychometric properties of the malay version of the EQ-5D in Malaysia.","volume":"3","author":"W-S Chen","year":"2010","journal-title":"SEGi Rev"},{"issue":"4","key":"pone.0256804.ref027","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s11136-010-9774-6","article-title":"A cross-sectional validation study of EQ-5D among the Malaysian adult population.","volume":"20","author":"AA Shafie","year":"2011","journal-title":"Quality of Life Research"},{"issue":"1","key":"pone.0256804.ref028","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s11136-018-2027-9","article-title":"Psychometric performance assessment of Malay and Malaysian English version of EQ-5D-5L in the Malaysian population.","volume":"28","author":"AA Shafie","year":"2019","journal-title":"Quality of Life Research"},{"issue":"5","key":"pone.0256804.ref029","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1007\/s40273-018-0758-7","article-title":"EQ-5D-5L valuation for the Malaysian population.","volume":"37","author":"AA Shafie","year":"2019","journal-title":"Pharmacoeconomics"},{"unstructured":"National Institute for Health and Clinical Excellence. Guide to the Methods of Technology Appraisal 2013: NICE London; 2013 [Available from: https:\/\/www.nice.org.uk\/process\/pmg9\/resources\/guide-to-the-methods-of-technology-appraisal-2013-pdf-2007975843781.","key":"pone.0256804.ref030"},{"unstructured":"EuroQol Group. EQ-5D-5L user guide. Basic information on how to use the EQ-5D-5L instrument. 2013 [Available from: https:\/\/www.unmc.edu\/centric\/_documents\/EQ-5D-5L.pdf.","key":"pone.0256804.ref031"},{"issue":"2","key":"pone.0256804.ref032","first-page":"78","article-title":"The epidemiology of chronic myeloid leukaemia in southern Sarawak, Borneo Island.","volume":"73","author":"JW Kuan","year":"2018","journal-title":"Med J Malaysia"},{"unstructured":"Seow A, Koh W, Chia K, Shi L, H. L. Trends in cancer incidence in Singapore 1968\u20132002. Singapore Cancer Registry Report No. 6. Singapore: Singapore Cancer Registry;. 2004.","key":"pone.0256804.ref033"},{"unstructured":"Curado M-P, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, et al. Cancer incidence in five continents, Volume IX: IARC Press, International Agency for Research on Cancer; 2007.","key":"pone.0256804.ref034"},{"issue":"1","key":"pone.0256804.ref035","first-page":"25","article-title":"Multivariate analysis of prognostic factors in Philadelphia chromosome positive chronic myeloid leukemia: an update of the first series in Thailand.","volume":"14","author":"S Jootar","year":"1996","journal-title":"Asian Pacific journal of allergy and immunology"},{"unstructured":"Chin NS. Chronic Myeloid Leukemia Clinical Practice Guideline Development Group (Malaysia) 2011 [Available from: http:\/\/haematology.org.my\/docs\/CMLCPG2011.pdf.","key":"pone.0256804.ref036"},{"issue":"22","key":"pone.0256804.ref037","first-page":"4439","article-title":"The price of drugs for chronic myeloid leukemia (CML) is a reflection of the unsustainable prices of cancer drugs: from the perspective of a large group of CML experts.","volume":"121","author":"EiCM Leukemia","year":"2013","journal-title":"Blood, The Journal of the American Society of Hematology."},{"unstructured":"Healthy People. Health-Related Quality of Life and Well-Being 2020 [Available from: https:\/\/www.healthypeople.gov\/2020\/about\/foundation-health-measures\/Health-Related-Quality-of-Life-and-Well-Being#:~:text=Health%2Drelated%20quality%20of%20life%20(HRQoL)%20is%20a%20multi,has%20on%20quality%20of%20life.","key":"pone.0256804.ref038"},{"issue":"5","key":"pone.0256804.ref039","first-page":"694","article-title":"Quality of life of the Malaysian general population: results from a postal survey using the SF-36","volume":"58","author":"A Azman","year":"2003","journal-title":"Medical Journal of Malaysia"},{"issue":"9","key":"pone.0256804.ref040","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/S1470-2045(11)70201-7","article-title":"Nilotinib versus imatinib for the treatment of patients with newly diagnosed chronic phase, Philadelphia chromosome-positive, chronic myeloid leukaemia: 24-month minimum follow-up of the phase 3 randomised ENESTnd trial.","volume":"12","author":"HM Kantarjian","year":"2011","journal-title":"The lancet oncology"},{"issue":"10","key":"pone.0256804.ref041","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1038\/leu.2012.134","article-title":"Nilotinib vs imatinib in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase: ENESTnd 3-year follow-up","volume":"26","author":"R Larson","year":"2012","journal-title":"Leukemia"},{"issue":"18","key":"pone.0256804.ref042","doi-asserted-by":"crossref","first-page":"2771","DOI":"10.1182\/blood-2014-09-601674","article-title":"Phase 3 study of nilotinib vs imatinib in Chinese patients with newly diagnosed chronic myeloid leukemia in chronic phase: ENESTchina","volume":"125","author":"J Wang","year":"2015","journal-title":"Blood"},{"issue":"9","key":"pone.0256804.ref043","first-page":"785","article-title":"Impact of age on the clinical response of patients with CML treated with imatinib.","volume":"61","author":"P B\u011blohl\u00e1vkov\u00e1","year":"2015","journal-title":"Vnitrni lekarstvi."},{"issue":"7","key":"pone.0256804.ref044","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.3324\/haematol.2011.056721","article-title":"Analysis of outcomes in adolescents and young adults with chronic myelogenous leukemia treated with upfront tyrosine kinase inhibitor therapy","volume":"97","author":"N Pemmaraju","year":"2012","journal-title":"Haematologica"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0256804","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T17:29:59Z","timestamp":1630085399000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0256804"}},"subtitle":[],"editor":[{"given":"Kingston","family":"Rajiah","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,8,27]]},"references-count":44,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0256804","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2021,8,27]]}}}