Childhood cancer symptom cluster: Leukemia and health-related quality of life

Cheryl C. Rodgers, Mary C. Hooke, Olga A. Taylor, Kari M. Koerner, Pauline A. Mitby, Ida M. Moore, Michael E. Scheurer, Marilyn J. Hockenberry, Wei Pan

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


OBJECTIVES: To examine the relationship of the Childhood Cancer Symptom Cluster-Leukemia (CCSC-L) with health-related quality of life (HRQOL).

SAMPLE & SETTING: 327 children receiving treatment for acute lymphoblastic leukemia from four pediatric oncology programs across the United States.

METHODS & VARIABLES: Participants completed fatigue, sleep disturbance, pain, nausea, and depression symptom questionnaires at four time points; these symptoms comprised the CCSC-L. HRQOL was measured at the start of postinduction therapy and then at the start of maintenance therapy. Relationships between the CCSC-L and HRQOL scores were examined with longitudinal parallel-process modeling.

RESULTS: The mean HRQOL significantly increased over time (p < 0.001). The CCSC-L had a significant negative association with HRQOL scores at the start of postinduction therapy (beta = -0.53, p < 0.005) and the start of maintenance therapy (beta = -0.33, p < 0.015). Participants with more severe symptoms in the CCSC-L over time had significantly lower HRQOL at the start of maintenance therapy (beta = -0.42, p < 0.005).

IMPLICATIONS FOR NURSING: Nurses are pivotal in providing management strategies to minimize symptom severity that may improve HRQOL.

Original languageEnglish (US)
Pages (from-to)228-237
Number of pages10
JournalOncology nursing forum
Issue number2
StatePublished - Mar 2019

Bibliographical note

Funding Information:
A repeated-measures design was used for this prospective study. This work was part of a larger study funded by the National Institutes of Health to characterize and explore associations of the phenotypic and genotypic characteristics in children experiencing symptoms related to leukemia treatment. The focus of this analysis is to identify

Funding Information:
This research was funded, in part, by a grant (RO1CA1693398) from the National Institutes of Health and through support from the Alex’s Lemonade Stand Foundation.

Publisher Copyright:
© 2019 Oncology Nursing Society. All rights reserved.


  • Health-related quality of life
  • Pediatric oncology
  • Symptom cluster
  • Cross-Sectional Studies
  • United States
  • Humans
  • Child, Preschool
  • Male
  • Quality of Life/psychology
  • Syndrome
  • Leukemia/nursing
  • Adolescent
  • Female
  • Surveys and Questionnaires
  • Child
  • Oncology Nursing/methods

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Journal Article
  • Research Support, N.I.H., Extramural


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