Financial toxicity and health-related quality of life in long-term survivors of acute promyelocytic leukaemia

objectives: we aimed to investigate the association between financial toxicity (FT) and the health-related quality of life profile of long-term survivors of acute promyelocytic leukaemia (APL) treated within a universal healthcare system. methods: we evaluated FT using the financial difficulties item of the european organisation for research and treatment of cancer quality of Life questionnaire-core 30 (EORTC QLQ-C30). we also compared the prevalence of clinically important problems and symptoms between the survivors of APL with or without FT, using evidence-based thresholds for the EORTC QLQ-C30. a multivariable logistic regression analysis was performed to explore potential risk factors associated with FT. results: overall, 352 long-term survivors of APL, with a median age of 53.9 years and a median time since diagnosis of 12.2 years, were analysed. of these, 71 (20.2%) reported having FTthe prevalence of clinically important problems and symptoms was generally higher across most EORTC QLQ-C30 scales for those survivors who reported FT. the three largest differences between patients with and without FT were observed for emotional functioning (+35.4 percentage points), dyspnoea (+33.1 percentage points) and physical functioning (+27.0 percentage points). the presence of FT was independently associated with having comorbidities and not receiving a salary/pension. conclusions: these findings suggest that even many years after being diagnosed, one-fifth of long-term survivors of APL experience FT. Interventions to assist with employment may be critical to minimise the risk of FT in the most vulnerable survivors.