Prevalence and clinical significance of restless legs syndrome in patients with chronic myeloid leukemia and its impact on quality of life and disease course

Aim: The aim of this study is to assess the prevalence of restless legs syndrome (RLS) in patients with chronic myeloid leukemia (CML) and to investigate the impact of RLS on the disease course and quality of life in these patients. Material and Method: Patients visiting the outpatient clinic consecutively between January and August 2023 were informed and invited to participate to the study. Control groups, including patients with iron deficiency (ID) and healthy individuals, were established. Demographic data, treatment regimens, complete blood counts, and biochemical analyses of the patients were documented. Electromyographic evaluations, neurological exams, and tests for RLS, anxiety, depression, fatigue, despair, and quality of life and sleep were conducted. Results: Study included 164 patients with CML, 22 with ID, and 23 healthy individuals. RLS was detected in 20.12% of CML patients (n=33), 45.5% in the ID group, while no RLS was detected in healthy subjects. The age, sex, risk score distribution, comorbidities, as well as the types and durations of tyrosine kinase inhibitor therapies were similar between CML patients with or without RLS. CML patients with RLS exhibited significantly worse sleep quality (p=0.016), anxiety (p<0.001), depression (p=0.005), fatigue (p<0.001), and overall life quality scores (p<0.001) compared to those without RLS. Multivariate analysis revealed that not using ACEis/ARBs reduced the risk of developing RLS (OR=0.235), while patients with a high cml24 symptom burden score had an increased risk (OR=1.077). Conclusion: The prevalence of RLS is increased in patients with CML, and the presence of RLS exacerbates anxiety, depression, and fatigue, while deteriorating sleep and overall quality of life. Investigating additional factors beyond those already identified that might play a role in the pathogenesis of RLS in CML could be important for understanding the etiology of RLS in these patients. Keywords: Chronic myeloid leukemia; myeloproliferative neoplasms; quality of life; restless legs syndrome