Health-related quality of life and cognitive outcomes among child and adolescent survivors of leukemia
- 338 Downloads
Long-term survival of childhood leukemia has become a reality with treatment advancement; hence, the need to assess the survivors’ health-related quality of life (HRQL) is essential. Although a growing number of Western studies have documented the considerable impact of diagnosis and treatment on HRQL in pediatric leukemia survivors, little finding has been reported in non-Western developing countries.
We used a previously validated 14-dimensional questionnaire, Child Health Questionnaire 50-item Parent Form (CHQ-PF 50), to examine the perceived HRQL of 32 child/adolescent survivors, currently aged 13.17 ± 2.49 years, who had experienced first complete continuous remission from leukemia for at least 3 years. The HRQL status was compared with that obtained from community subjects (N = 154) and survivors’ nonadult siblings (N = 30). Intelligence quotients (IQ) and computerized neuropsychological assessments were performed for subjects.
The HRQL of leukemia survivors was noted to be worse than that of community children and nonadult siblings as reflected by significantly lower scores in both the physical summary and the psychosocial summary score of CHQ-PF 50. 15.6% of the survivors had impaired intelligence (estimated IQ below 70). 27.8% of the adolescents were impaired in the cognitive domains as assessed by neuropsychological tests.
In this Taiwanese single institution experience, pediatric leukemia survivors carried a morbidity burden into their teen years as reflected by worse HRQL than controls. These findings may guide the support required by this population.
KeywordsCancer survivor Health-related quality of life Pediatric leukemia Adolescent
- 2.Silverman LB, Gelber RD, Dalton VK, Asselin BL, Barr RD, Clavell LA, Hurwitz CA, Moghrabi A, Samson Y, Schorin MA, Arkin S, Declerck L, Cohen HJ, Sallan SE (2001) Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber Consortium Protocol 91–01. Blood 97:1211–1218CrossRefPubMedGoogle Scholar
- 3.Geenen MM, Cardous-Ubbink MC, Kremer LC, van den Bos C, van der Pal HJ, Heinen RC, Jaspers MW, Koning CC, Oldenburger F, Langeveld NE, Hart AA, Bakker PJ, Caron HN, van Leeuwen FE (2007) Medical assessment of adverse health outcomes in long-term survivors of childhood cancer. JAMA 297:2705–2715CrossRefPubMedGoogle Scholar
- 17.Liang DC, Hung IJ, Yang CP, Lin KH, Chen JS, Hsiao TC, Chang TT, Pui CH, Lee CH, Lin KS (1999) Unexpected mortality from the use of E. coli L-asparaginase during remission induction therapy for childhood acute lymphoblastic leukemia: a report from the Taiwan Pediatric Oncology Group. Leukemia 13:155–160CrossRefPubMedGoogle Scholar
- 19.Landgraf JM, Abetz L, Ware JE (1999) The CHQ User’s manual. HealthAct, Boston, MAGoogle Scholar
- 21.Wechsler D (1991) Manual for the Wechsler intelligence scale for children, 3rd. Psychological Corp, New YorkGoogle Scholar
- 22.Sattler J (1992) Assessment of children, revised and updated version. JM Sattler Publisher, Inc, San DiegoGoogle Scholar
- 23.Wechsler D (1997) Wechsler adult intelligence scale III. Psychological Corporation, San Antonio, TexGoogle Scholar
- 26.Cohen J (1977) Statistical power analysis for behavioral science (Revised Edition). Academic, New YorkGoogle Scholar
- 32.Langer T, Martus P, Ottensmeier H, Hertzberg H, Beck JD, Meier W (2002) CNS late-effects after ALL therapy in childhood. Part III: neuropsychological performance in long-term survivors of childhood ALL: impairments of concentration, attention, and memory. Med Pediatr Oncol 38:320–328CrossRefPubMedGoogle Scholar
- 35.von der Weid N, Mosimann I, Hirt A, Wacker P, Nenadov Beck M, Imbach P, Caflisch U, Niggli F, Feldges A, Wagner HP (2003) Intellectual outcome in children and adolescents with acute lymphoblastic leukaemia treated with chemotherapy alone: age- and sex-related differences. Eur J Cancer 39:359–365CrossRefPubMedGoogle Scholar