丹麦和瑞典儿童急性淋巴细胞白血病幸存者的精神障碍。

IF 2.4 3区 医学 Q2 HEMATOLOGY
Gitte V. Sørensen, Hanna Mogensen, Anna S. Holmqvist, Line Kenborg, Camilla Pedersen, Thomas T. Nielsen, Mats Talbäck, Friederike Erdmann, Marianne Ifversen, Maria Feychting, Kjeld Schmiegelow, Mats M. Heyman, Jeanette F. Winther, Henrik Hasle, Line E. Frederiksen
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引用次数: 0

摘要

背景:儿童急性淋巴细胞白血病(ALL)的诊断和治疗可能会影响心理健康。我们在一项基于人群的队列研究中调查了ALL幸存者患精神疾病的长期风险:我们确定了1982-2008年期间丹麦和瑞典20岁以前确诊为ALL的患者。我们对ALL幸存者(n = 2026)、他们的兄弟姐妹(n = 3027)和人群对比对象(n = 9713)进行了跟踪调查,以了解他们在ALL确诊后5年(或相应的指数日期)至2017年期间因精神障碍而住院的情况:到30岁时,ALL幸存者接触精神病院的绝对风险为19.9%(95%置信区间[CI]:17.9-22.1),兄弟姐妹为18.5%(95%置信区间:16.9-20.2),对比人群为18.3%(95%置信区间:17.3-19.2)。总体而言,幸存者罹患任何精神疾病的风险均高于兄弟姐妹(危险比 [HR] = 1.25;95% CI:1.04-1.50)和人群对比受试者(HR = 1.20;95% CI:1.06-1.35)。接受造血干细胞移植(HSCT)和/或复发的幸存者亚组(n = 332)罹患精神疾病的风险最高(与同胞相比,HR = 2.07;95% CI:1.26-3.41;与人群比较对象相比,HR = 1.67;95% CI:1.25-2.23):结论:ALL幸存者接触精神病院的总体绝对风险与同胞兄弟姐妹和人群对比对象接近。相对风险略有增加的主要原因是接受造血干细胞移植和/或病情复发的幸存者亚群。我们的研究结果让大量未接受造血干细胞移植或病情未复发的ALL幸存者感到欣慰,并为精神疾病患者接触医院的绝对风险和相对风险提供了新的视角。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Psychiatric disorders among survivors of childhood acute lymphoblastic leukemia in Denmark and Sweden

Psychiatric disorders among survivors of childhood acute lymphoblastic leukemia in Denmark and Sweden

Background

The diagnosis and treatment of childhood acute lymphoblastic leukemia (ALL) may impact mental health. We investigated the long-term risk of psychiatric disorders among survivors of ALL in a population-based cohort study.

Methods

We identified patients diagnosed with ALL in Denmark and Sweden before age 20 during 1982–2008. Survivors of ALL (n = 2026), their siblings (n = 3027), and population comparison subjects (n = 9713) were followed for hospital contacts for psychiatric disorders from 5 years after ALL diagnosis (or corresponding index date) until 2017.

Results

By age 30, the absolute risk of psychiatric hospital contacts was 19.9% (95% confidence interval [CI]: 17.9–22.1) for ALL survivors, 18.5% (95% CI: 16.9–20.2) for siblings, and 18.3% (95% CI: 17.3–19.2) for population comparison subjects. Overall, survivors were at higher risk of any psychiatric disorders than siblings (hazard ratio [HR] = 1.25; 95% CI: 1.04–1.50), and population comparison subjects (HR = 1.20; 95% CI: 1.06–1.35). The subgroup of survivors (n = 332) who received a hematopoietic stem cell transplantation (HSCT) and/or had a relapse were at highest risk of psychiatric disorders (HR = 2.07; 95% CI: 1.26–3.41 compared to siblings; HR = 1.67; 95% CI: 1.25–2.23 compared to population comparison subjects).

Conclusions

The overall absolute risk of psychiatric hospital contacts among ALL survivors was close to that in siblings and population comparison subjects. The modestly increased relative risk was mainly driven by the subgroup of survivors who received HSCT and/or had a relapse. Our findings are reassuring for the large subgroup of ALL survivors without HSCT or relapse, and provide novel insight on both absolute and relative risk of hospital contacts for psychiatric disorders.

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来源期刊
Pediatric Blood & Cancer
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.
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