Quality of life and late therapy effects in pediatric non-Hodgkin lymphoma survivors: Insights from a single-institution study

IF 2.4 3区医学 Q2 HEMATOLOGY

Pediatric Blood & Cancer Pub Date : 2024-10-06 DOI:10.1002/pbc.31357

Azza Ayad, Reham Khedr, Asmaa Hamoda, Nahla Elnabarawy, Elhamy Rifky, Tamer Diab, Eman El Desouky, Leslie Lehmann, Alaa Elhaddad

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Abstract

Background and aim

The survival outcomes of pediatric patients with mature B-non-Hodgkin lymphoma (NHL) have improved due to advances in treatment. We aimed to assess the frequency and severity of late effects and their impact on quality of life among pediatric NHL survivors.

Patients and methods

This retrospective study included patients diagnosed with mature B-NHL at Children's Cancer Hospital of Egypt (CCHE) 57357 from January 2012 through December 2015. Patients received treatment according to the modified LMB 96 protocol. The minimum follow-up period was 5 years. Assessments for toxicity and quality of life were conducted at regular intervals during and after treatment. Patients were assessed for toxicity including pulmonary dysfunction, cardiac dysfunction, lipid profile abnormalities, endocrine dysfunction (thyroid function, vitamin D levels, growth curves), and cognitive function (intelligence quotient [IQ] level using Stanford–Binet Intelligence Scales—5th Edition, and quality of life (QoL) assessment (PedsQoL).

Results

A total of 273 patients were eligible, and 206 were evaluable. Median age was 5.45 (range: 2.4–18), with a male-to-female ratio 4:1. Pulmonary function abnormalities were detected in 119/203 (58.6%); most had mild dysfunction (72/119, 60.5%), while 17% had severe dysfunction. Cardiac toxicity occurred in 10% of the patients (n = 20). IQ testing showed that 52 patients had a low average IQ score, while 151 patients had either average or above average scores. The total mean QoL score was 99 ± 0.058 classified as “satisfactory.” However, significant impairment of the physical domain of quality of life was observed among group C patients compared to A/B (p = .033), older age at diagnosis (p = .042), and those with pulmonary dysfunction (p < .001). Total score of quality of life was significantly impaired among patients with pulmonary dysfunction (p = .009), likewise older age at diagnosis (p = .017) and those with low average IQ scores (p = .033).

Conclusion

Childhood mature B-NHL survivors are at significant risk for late effects; pulmonary dysfunction and low average IQ that can subsequently impact QoL

查看原文本刊更多论文

儿科非霍奇金淋巴瘤幸存者的生活质量和后期治疗效果：一项单一机构研究的启示。

背景和目的：由于治疗方法的进步，成熟B型非霍奇金淋巴瘤（NHL）儿科患者的生存率有所提高。我们旨在评估晚期效应的频率和严重程度及其对儿科 NHL 幸存者生活质量的影响：这项回顾性研究纳入了2012年1月至2015年12月期间在埃及儿童癌症医院（CCHE）57357确诊为成熟B-NHL的患者。患者按照修改后的LMB 96方案接受治疗。随访期最短为 5 年。治疗期间和治疗后定期进行毒性和生活质量评估。患者的毒性评估包括肺功能障碍、心功能障碍、血脂异常、内分泌功能障碍（甲状腺功能、维生素D水平、生长曲线）和认知功能（使用斯坦福-比奈智力测验量表-5th版的智商[IQ]水平和生活质量（QoL）评估（PedsQoL））：共有 273 名患者符合条件，其中 206 名可接受评估。中位年龄为 5.45 岁（2.4-18 岁），男女比例为 4:1。119/203（58.6%）例患者出现肺功能异常；大多数患者有轻度功能障碍（72/119，60.5%），17%有严重功能障碍。10%的患者（20 人）出现心脏毒性。智商测试显示，52 名患者的平均智商得分较低，而 151 名患者的平均智商得分或高于平均得分。平均 QoL 总分为 99 ± 0.058 分，被列为 "满意"。然而，与 A/B 组（p = .033）、诊断时年龄较大（p = .042）和有肺功能障碍（p 结论：C 组患者的生活质量在身体方面明显受损：儿童期成熟 B-NHL 幸存者极有可能受到晚期影响；肺功能障碍和低平均智商会影响生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Blood & Cancer 医学-小儿科

CiteScore

4.90

自引率

9.40%

发文量

546

审稿时长

1.5 months

期刊介绍： Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.