Gehan Premaratne, Maria McCarthy, Michelle Tennant, Peter Downie, Stephen Hearps, Cinzia De Luca
{"title":"接受急性淋巴细胞白血病（ALL）治疗的儿童和青少年与健康同龄人相比的健康相关生活质量：一项早期生存的纵向研究","authors":"Gehan Premaratne, Maria McCarthy, Michelle Tennant, Peter Downie, Stephen Hearps, Cinzia De Luca","doi":"10.1007/s11764-024-01736-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Survival for childhood Acute Lymphoblastic Leukaemia (ALL) has surpassed 90%, making quality of survival an important endpoint in treatment outcomes. This study examined health-related quality of life (HRQoL) trajectories in early survivorship for patients post-ALL treatment compared with a matched group of healthy peers, and explored the association of individual factors (age, sex) and treatment intensity with HRQoL outcomes.</p><p><strong>Methods: </strong>Eighty-three paediatric patients aged 4-16 years who recently completed treatment for ALL were recruited to the study, alongside 53 age- and sex-matched healthy children. All participants completed the self-report Pediatric Quality of Life Inventory (PedsQL) generic score scale at 3-, 15- and 27-months post-study enrolment.</p><p><strong>Results: </strong>Trajectory of overall HRQoL for the patient group declined over time, falling below clinical cutoffs at 27 months. Subscale trajectories differed between groups, with patients' emotional and social functioning negatively diverging relative to healthy peers, while school functioning remained consistently reduced. Children treated for ALL experienced significantly poorer HRQoL compared to healthy peers at 27 months post-treatment (p = 0.027, ES = - 0.47) with moderate effect sizes, reflecting lower social functioning (p = 0.044, ES = - 0.42) and school functioning (p = 0.011, ES = - 0.52). Age and sex were not associated with overall HRQoL at 27 months; however, younger age was associated with reduced emotional functioning in the standard treatment-intensity group.</p><p><strong>Conclusion and implications: </strong>HRQoL is impaired in children treated for ALL in early survivorship, particularly across social and school functioning domains. Screening using patient-reported outcomes is reliable at identifying young people at risk and has potential to guide psychosocial interventions in this early off-treatment period.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Health-related Quality of Life in children and adolescents treated for acute lymphoblastic leukaemia (ALL), compared with healthy peers: a longitudinal study of early survivorship.\",\"authors\":\"Gehan Premaratne, Maria McCarthy, Michelle Tennant, Peter Downie, Stephen Hearps, Cinzia De Luca\",\"doi\":\"10.1007/s11764-024-01736-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Survival for childhood Acute Lymphoblastic Leukaemia (ALL) has surpassed 90%, making quality of survival an important endpoint in treatment outcomes. This study examined health-related quality of life (HRQoL) trajectories in early survivorship for patients post-ALL treatment compared with a matched group of healthy peers, and explored the association of individual factors (age, sex) and treatment intensity with HRQoL outcomes.</p><p><strong>Methods: </strong>Eighty-three paediatric patients aged 4-16 years who recently completed treatment for ALL were recruited to the study, alongside 53 age- and sex-matched healthy children. All participants completed the self-report Pediatric Quality of Life Inventory (PedsQL) generic score scale at 3-, 15- and 27-months post-study enrolment.</p><p><strong>Results: </strong>Trajectory of overall HRQoL for the patient group declined over time, falling below clinical cutoffs at 27 months. Subscale trajectories differed between groups, with patients' emotional and social functioning negatively diverging relative to healthy peers, while school functioning remained consistently reduced. Children treated for ALL experienced significantly poorer HRQoL compared to healthy peers at 27 months post-treatment (p = 0.027, ES = - 0.47) with moderate effect sizes, reflecting lower social functioning (p = 0.044, ES = - 0.42) and school functioning (p = 0.011, ES = - 0.52). Age and sex were not associated with overall HRQoL at 27 months; however, younger age was associated with reduced emotional functioning in the standard treatment-intensity group.</p><p><strong>Conclusion and implications: </strong>HRQoL is impaired in children treated for ALL in early survivorship, particularly across social and school functioning domains. 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引用次数: 0
摘要
目的：儿童急性淋巴细胞白血病（ALL）的生存率已超过90%，使生存质量成为治疗结果的重要终点。本研究考察了all治疗后患者早期生存期的健康相关生活质量（HRQoL）轨迹，并与匹配组的健康同龄人进行了比较，探讨了个体因素（年龄、性别）和治疗强度与HRQoL结果的关系。方法：83名最近完成ALL治疗的4-16岁儿童患者被招募到研究中，同时还有53名年龄和性别匹配的健康儿童。所有参与者在研究入组后3个月、15个月和27个月完成儿童生活质量量表（PedsQL）通用评分量表的自我报告。结果：患者组的总体HRQoL轨迹随着时间的推移而下降，在27个月时低于临床临界值。各组之间的亚量表轨迹不同，患者的情感和社会功能相对于健康同龄人呈负向分化，而学校功能则持续下降。治疗后27个月，ALL患儿的HRQoL明显低于健康同龄人（p = 0.027, ES = - 0.47），效应大小中等，反映出较低的社会功能（p = 0.044, ES = - 0.42）和学校功能（p = 0.011, ES = - 0.52）。27个月时，年龄和性别与总体HRQoL无关；然而，在标准治疗强度组中，年龄越小情绪功能越弱。结论和意义：急性淋巴细胞白血病（ALL）患儿早期生存期的HRQoL受损，尤其是在社会和学校功能领域。使用患者报告的结果进行筛查，在确定有风险的年轻人方面是可靠的，并有可能在这一早期非治疗期指导社会心理干预。
Health-related Quality of Life in children and adolescents treated for acute lymphoblastic leukaemia (ALL), compared with healthy peers: a longitudinal study of early survivorship.
Purpose: Survival for childhood Acute Lymphoblastic Leukaemia (ALL) has surpassed 90%, making quality of survival an important endpoint in treatment outcomes. This study examined health-related quality of life (HRQoL) trajectories in early survivorship for patients post-ALL treatment compared with a matched group of healthy peers, and explored the association of individual factors (age, sex) and treatment intensity with HRQoL outcomes.
Methods: Eighty-three paediatric patients aged 4-16 years who recently completed treatment for ALL were recruited to the study, alongside 53 age- and sex-matched healthy children. All participants completed the self-report Pediatric Quality of Life Inventory (PedsQL) generic score scale at 3-, 15- and 27-months post-study enrolment.
Results: Trajectory of overall HRQoL for the patient group declined over time, falling below clinical cutoffs at 27 months. Subscale trajectories differed between groups, with patients' emotional and social functioning negatively diverging relative to healthy peers, while school functioning remained consistently reduced. Children treated for ALL experienced significantly poorer HRQoL compared to healthy peers at 27 months post-treatment (p = 0.027, ES = - 0.47) with moderate effect sizes, reflecting lower social functioning (p = 0.044, ES = - 0.42) and school functioning (p = 0.011, ES = - 0.52). Age and sex were not associated with overall HRQoL at 27 months; however, younger age was associated with reduced emotional functioning in the standard treatment-intensity group.
Conclusion and implications: HRQoL is impaired in children treated for ALL in early survivorship, particularly across social and school functioning domains. Screening using patient-reported outcomes is reliable at identifying young people at risk and has potential to guide psychosocial interventions in this early off-treatment period.
期刊介绍：
Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.
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