Patient-centered transfusion care for patients with chronic myeloid leukemia: health-related quality of life

To synthesize contemporary evidence on patient-centered transfusion care for chronic myeloid leukemia (CML) – integrating Patient Blood Management (PBM) principles with systematic assessment of health-related quality of life (HRQoL) – and to outline practical implications for Ukrainian clinical practice. Materials and methods. Narrative review of international guidance (ELN/NCCN), Ukrainian normative documents, and peer-reviewed studies on transfusion practice, PBM, HRQoL, and treatment-free remission (TFR) in CML. Particular attention was paid to national protocol materials and local biomarker data that quantify endogenous metabolic intoxication and may influence supportive-care needs. Evidence was appraised for clinical applicability to ambulatory and inpatient pathways, including monitoring frameworks and shared decision-making. Results. Modern CML management requires moving beyond disease-oriented targets toward outcomes that matter to patients: symptom burden, functional status, and participation. Validated PRO instruments consistently show that fatigue, pain, sleep disturbance, and social limitations remain salient despite effective tyrosine-kinase inhibitor (TKI) therapy; fatigue is a leading limiter of HRQoL. Embedding routine PRO capture into follow-up strengthens timely toxicity management, adherence support, and suitability assessment for TFR. PBM operationalizes individualized, conservative use of allogeneic components by optimizing erythropoiesis, minimizing iatrogenic blood loss, and applying restrictive, reassessment-driven transfusion triggers within multidisciplinary care. In parallel, Ukrainian protocolized pathways standardize diagnostics and monitoring (hematologic/cytogenetic/molecular milestones) and can be leveraged to hard-wire PBM and PROs into routine care. Local biochemical observations–rising plasma medium-mass molecules with advancing phase and partial reversibility under treatment–underscore the biological substrate of metabolic intoxication that tracks with clinical decompensation and potential transfusion demand, reinforcing the value of anticipatory supportive strategies. Conclusions. A patient-centered CML program integrates guideline-directed molecular control with PBM-based transfusion stewardship and systematic HRQoL surveillance. Such integration reduces exposure to transfusion-related harm, targets correctable causes of anemia, captures what patients experience, and aligns decisions (including TFR) with individual preferences and risks. Within Ukraine’s standardized CML pathways, embedding PBM bundles and PRO dashboards is both feasible and desirable to improve clinical and person-reported outcomes.