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Determinants of quality of life during induction therapy in pediatric acute lymphoblastic leukemia

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Abstract

Purpose

Improvement in survival of pediatric acute lymphoblastic leukemia (ALL) has increased the attention to quality of life (QoL) . QoL is impaired during maintenance treatment, but little is known about QoL during induction therapy. Identification of patients with poor QoL during induction will provide opportunities for early interventions, and may subsequently improve future QoL. This national multi-center study aimed to assess QoL and its determinants during ALL induction treatment.

Methods

Proxy reports of the Child Health Questionnaire (CHQ) and the PedsQL cancer version were collected. Child, treatment, and parental characteristics were analyzed as potential determinants in a multiple regression model.

Results

One hundred thirty parents of children participated (response rate 82 %), median child age was 5.7 years and 48 % were female. QoL, as measured with the CHQ, was significantly lower than the norm, the effect sizes were large, and the differences were clinically relevant. Physical QoL was more often affected than psychosocial QoL. Regression models could be constructed for 4/ 10 CHQ scales and 6/ 8 PedsQL cancer scales, accounting for 7 to 36 % of the variance in scores. Impaired QoL was most often associated with older children, girls, and time since diagnosis. Also, father respondents seem to have a lower QoL perception compared to mother respondents although this needs to be confirmed in future research.

Conclusions

Specific counseling for subsets of patients with a higher risk of low QoL during the early phases of therapy is warranted.

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Acknowledgments

We would like to thank the DCOG data managers, local physicians, and study managers in all participating centers for including participants and keeping us updated on their clinical condition. Also, we thank Esther Meijer-van den Bergh for helping with the initial design and continuation of this project.

Conflicts of interest

The authors declare that there is no conflict of interest. No financial support was received. The authors are in full control of all primary data and agree to allow Supportive Care in Cancer to review the data if requested.

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Authors and Affiliations

  1. Department of Pediatrics, VU University Medical Center Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands

    Raphaële R. L. van Litsenburg & Reinoud J. B. J. Gemke

  2. Department of Medical Psychology, VU University Medical Center Amsterdam, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands

    Jaap Huisman

  3. Department of Pediatric Psychology and Social Work, University Medical Center Utrecht, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands

    Jaap Huisman

  4. Dutch Childhood Oncology Group, The Hague and Department of Pediatrics, Division of Oncology-Hematology , Erasmus MC - Sophia Children’s Hospital Rotterdam, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands

    Rob Pieters

  5. Department of Medical Psychology, University Medical Center St Radboud, P.O. box 9101, 6500 HB, Nijmegen, The Netherlands

    Chris Verhaak

  6. Department of Pediatrics, Division of Oncology-Hematology , VU University Medical Center Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands

    Raphaële R. L. van Litsenburg & Gertjan J. L. Kaspers

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  1. Raphaële R. L. van Litsenburg
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  2. Jaap Huisman
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  3. Rob Pieters
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  5. Gertjan J. L. Kaspers
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  6. Reinoud J. B. J. Gemke
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Correspondence to Raphaële R. L. van Litsenburg.

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van Litsenburg, R.R.L., Huisman, J., Pieters, R. et al. Determinants of quality of life during induction therapy in pediatric acute lymphoblastic leukemia. Support Care Cancer 22, 3235–3242 (2014). https://doi.org/10.1007/s00520-014-2349-2

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  • DOI: https://doi.org/10.1007/s00520-014-2349-2

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