Chronic Myeloid Leukemia Coverage from Every Angle

Cognitive Behavioral Therapy via FaceTime for TKI-Related Fatigue in CML

By: Sarah Campen, PharmD
Posted: Friday, October 25, 2019

Fatigue is one of the most common and debilitating side effects of treatment with tyrosine kinase inhibitors (TKIs) in patients with chronic myeloid leukemia (CML) and is associated with large deficits in quality of life. A randomized pilot trial published in Cancer found that Internet-assisted cognitive behavioral therapy may be effective in improving fatigue and quality of life in patients with targeted therapy–related fatigue.

“This pilot study suggests that Internet-assisted [cognitive behavioral therapy for targeted therapy–related fatigue] is a promising intervention for fatigue due to targeted therapies,” stated Heather S. L. Jim, PhD, of Moffitt Cancer Center, Tampa, and colleagues. “This line of research may provide new opportunities for improving patient quality of life after a cancer diagnosis.”

The researchers recruited 44 patients with CML treated with a TKI who reported moderate to severe fatigue. Participants were randomly assigned 2:1 to 18 weeks of cognitive behavioral therapy for targeted therapy–related fatigue delivered by FaceTime for an iPad (n = 29) or a waitlist control group (n = 15). Each session followed a basic format of problem recognition, solution generation, implementation, and progress evaluation; sessions were scheduled at 1- or 2-week intervals, depending on participants’ progress in meeting therapy goals.

Patients in the cognitive behavioral therapy group had significantly greater improvements in the severity of fatigue (P < .001) and overall quality of life (P = .005) than did those in the waitlist control group. Clinically significant improvements in fatigue and overall quality of life were observed in 85% and 88% of patients receiving therapy compared with 29% and 54% of patients in the control group, respectively. The completion rate of the study was “acceptable and feasible,” according to the study authors, with 22 of the 28 patients (79%) assigned to cognitive behavioral therapy receiving at least 10 sessions.

Disclosure: For full disclosures of the study authors, visit

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