Due to recent changes in how acute leukemia is treated, there is an urgent need for greater understanding of quality of life (QoL) at different points in the acute leukemia patient journey.

Purpose

We sought to determine which factors are most associated with poor quality of life (QoL) in patients with acute leukemia and to determine key issues and unmet needs through administration of an online survey distributed worldwide via partner patient organizations.

Background to project

Acute leukemia is a malignant disease of the blood in which a particular type of a blood cell, typically at an immature stage of development, rapidly expands in the blood or bone marrow. The two most common subtypes of acute leukemia are ALL and AML.

• ALL is caused by the expansion of immature lymphoid precursors, and typically affects young children and older adults.
• In AML, it is the precursor cells of the bone marrow that rapidly multiply. This form of acute leukemia is the most common in adults. Acute leukemia is an aggressive disease; progresses extremely rapidly without treatment; and has historically been associated with poor outcomes in adults.

This acute and life-threatening disease puts a significant burden on patients and their families, who can experience extremely high stress levels, as well as negative psychological and physiological effects due to the aggressive nature of the disease.

Acute leukemias are a highly heterogeneous; within AML and ALL, there are numerous subtypes, which are defined by the identity and developmental stage of the affected cells. The prognosis and risk associated with each sub-type is often determined by the genetic mutations. Further complicating the treatment of this disease is the fact that the cells may continue to change their genetic characteristics as the disease progresses.

A number of promising new treatments are becoming available that use this diversity to target specific mutations that drive disease progression in leukemic cells.

While targeted therapies focus on what differentiates the leukemic cells, other approaches aim to modulate more fundamental processes that do not depend on specific genetic mutations, for example, molecules that target apoptosis pathways. The development of non-chemotherapy treatments is a promising advancement, particularly for elderly patient groups who may not be fit enough to undergo grueling treatment regimes, and strategies for combining different therapies, as well as novel technologies to monitor disease progression and response to medicines, have great potential for making a real difference in the treatment of this devastating disease.