Acute Myeloid Leukemia (AML)

Acute Myeloid Leukemia (AML): Impact of diagnostic and treatments on patients’ lives and their families

Diagnosis

1. What was your age at diagnosis?*

<18 years old

19-30 years old

31-49 years old

50-64 year old

65+ years old

2. How long ago did you receive your diagnosis?*

less than 6 months

6 to 12 months

1 to 2 years

2 to 5 years

More than five years

3. How long did it take before getting your AML diagnosis?

Less than a week

Less than a month

Less than three months

More than three months

4. In which city and country did you live at diagnosis?*

Diagnosis: Mutation tests

5. Did you received some tests to identify the mutation involved in your AML?*

No

Yes

Treatments

6. What types of treatment have you received or are you receiving? Select all options that apply to your situation*

Watch and wait

Chemotherapy oral taken at home

Chemotherapy with injection in the hospital or cancer center

Transplantation

Other (please specify)

6. What types of treatment have you received or are you receiving? Select all options that apply to your situation (Specify)*

7. Have you experienced any delays in receiving AML treatment?*

No

Yes (please specify for which treatment)

7. Have you experienced any delays in receiving AML treatment? (Specify)*

8. Did you have to move to receive your AML treatments?*

No

Yes (please specify for which treatment)

8. Did you have to move to receive your AML treatments? (Specify)*

Long-term treatment response

9. Did your cancer doctor explain that your cancer can come back, you can relapse and need more treatment?*

No

Yes

10. How stressful is to think that your cancer can come back? From 0 (no stress at all) to 100 (severe stress and anxiety)*

11. Is having a treatment to reduce your risk of relapsing and prolong your survival would alleviate some of the stress related to your cancer?*

No

Yes

12. How important is for you to prolong the response to your treatment and avoid the disease to come back? From 0 (not important) to 100 (extremely important)*

Name

This field is for validation purposes and should be left unchanged.