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Chemotherapy-related symptoms in children with leukemia: application of latent profile analysis and network analysis

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Abstract

Purpose

Children with leukemia may experience a range of chemotherapy-related symptoms. Identifying subgroups and their distinct characteristics of symptoms may improve symptom management. We aimed to identify subgroups and their distinct characteristics of chemotherapy-related symptoms in children with leukemia.

Methods

A cross-sectional survey was conducted among 500 children with leukemia, who completed questionnaires that assessed their demographic and clinical characteristics, as well as the Memorial Symptom Assessment Scale. Latent profile analysis was conducted to identify subgroups of symptoms. Additionally, multiple regression analysis and network analysis were utilized to reveal the characteristics of each subgroup.

Results

Four subgroups were identified: “Profile 1: low symptom burden subgroup” (26.2%), “Profile 2: moderate symptom burden subgroup in transitional period” (14.8%), “Profile 3: moderate psychological symptom burden subgroup” (35.6%), and “Profile 4: high symptom burden subgroup” (23.4%). Multiple logistic regression analysis indicated that lower primary caregiver’s education level, lower family monthly income, self-paid medical expenses, induction remission period, and consolidation enhancement period were associated with more severe symptoms of subgroups. Network analysis further revealed that nausea was the core symptom in Profiles 1 and 2, while the core symptom in Profile 3 was “I don’t look like myself.” Additionally, worrying was the core symptom in Profile 4.

Conclusion

There exists heterogeneity in chemotherapy-related symptoms. Four subgroups and their corresponding characteristics of children with varying symptom severity were identified. Identifying these subgroups will facilitate personalized care, maximize intervention effectiveness, and alleviate symptom burden.

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Data availability

The data that support the findings of this study are available from the Guangzhou Women and Children’s Medical Center but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of the Guangzhou Women and Children’s Medical Center.

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Acknowledgements

The authors thank the clinical staff for their support and all the participants in this study.

Funding

This research was funded by grants from the Guangzhou Health Science and Technology Project (No. 20241A010020).

Author information

Authors and Affiliations

  1. Department of Nursing, Guangzhou Women and Children’s Medical Center, No.9 Huasui Road, Guangzhou, 510620, China

    Meixiang Wang, Xiaoyan Hu & Yan Lin

  2. School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China

    Meixiang Wang

  3. School of Nursing, Guangzhou Medical University, Guangzhou, China

    Jia Fang

  4. School of Nursing, Fudan University, Shanghai, China

    Tingting Cai & Fulei Wu

Authors
  1. Meixiang Wang
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  2. Jia Fang
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  3. Xiaoyan Hu
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  4. Tingting Cai
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  5. Fulei Wu
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  6. Yan Lin
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Contributions

Conceptualization: Meixiang Wang, Jia Fang, Yan Lin. Methodology: Meixiang Wang, Jia Fang. Formal analyses and investigation: Meixiang Wang, Jia Fang, Xiaoyan Hu. Writing—original draft preparation: Meixiang Wang. Writing—review and editing: Tingting Cai, Fulei Wu, Yan Lin. All authors have read and approved the final version of the manuscript to be published. The authors ensure that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding authors

Correspondence to Jia Fang or Yan Lin.

Ethics declarations

Ethics approval

The use of data was approved by the Guangzhou Women and Children’s Medical Center (2022-240A01) and our research was conducted in accordance with the Declaration of Helsinki.

Consent to participate

Informed consent was obtained from all individual participants and their primary caregiver included in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

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Meixiang Wang, Jia Fang, and Xiaoyan Hu contributed equally to this work and should be regarded as co-first authors.

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Cite this article

Wang, M., Fang, J., Hu, X. et al. Chemotherapy-related symptoms in children with leukemia: application of latent profile analysis and network analysis. Support Care Cancer 32, 207 (2024). https://doi.org/10.1007/s00520-024-08410-9

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