Health conditions and quality of life in survivors of childhood acute myeloid leukemia comparing post remission chemotherapy to BMT: A report from the children's oncology group

Kris Ann P Schultz, Lu Chen, Zhengjia Chen, Toana Kawashima, Kevin C. Oeffinger, William G. Woods, H. Stacy Nicholson, Joseph P Neglia

Research output: Contribution to journalArticle

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Abstract

Background: Therapy for childhood acute myeloid leukemia (AML) has historically included chemotherapy with or without autologous bone marrow transplant (autoBMT) or allogeneic hematopoietic stem cell transplantation (alloBMT). We sought to compare health-related quality-of-life (HRQOL) outcomes between these treatment groups. Procedure: Five-year survivors of AML diagnosed before age 21 and enrolled and treated from 1979 to 1995 on one of 4 national protocols were interviewed. These survivors or proxy caregivers completed a health questionnaire and an HRQOL measure. Results: Of 180 survivors, 100 were treated with chemotherapy only, 26 with chemotherapy followed by autoBMT, and 54 with chemotherapy followed by alloBMT. Median age at interview was 20 years (range 8-39). Twenty-one percent reported a severe or life-threatening chronic health condition (chemotherapy-only 16% vs. autoBMT 21% vs. alloBMT 33%; P=0.02 for chemotherapy-only vs. alloBMT). Nearly all (95%) reported excellent, very good or good health. Reports of cancer-related pain and anxiety did not vary between groups. HRQOL scores among 136 participants ≥14 years of age were similar among groups and to the normative population, though alloBMT survivors had a lower physical mean summary score (49.1 alloBMT vs. 52.2 chemotherapy-only; P=0.03). Multivariate analyses showed the presence of severe chronic health conditions to be a strong predictor of physical but not mental mean summary scores. Conclusions: Overall HRQOL scores were similar among treatment groups, although survivors reporting more health conditions or cancer-related pain had diminished HRQOL. Attention to chronic health conditions and management of cancer-related pain may improve QOL. Pediatr Blood Cancer 2014;61:729-736.

Original languageEnglish (US)
Pages (from-to)729-736
Number of pages8
JournalPediatric Blood and Cancer
Volume61
Issue number4
DOIs
StatePublished - Apr 1 2014

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Acute Myeloid Leukemia
Survivors
Quality of Life
Drug Therapy
Health
Bone Marrow
Transplants
Hematopoietic Stem Cell Transplantation
Proxy
Caregivers
Multivariate Analysis
Anxiety
Interviews
Therapeutics
Population
Cancer Pain
Neoplasms

Keywords

  • Acute myeloid leukemia
  • Bone marrow transplantation
  • Chronic health condition
  • Late effects
  • Pediatric
  • Quality of life

Cite this

Health conditions and quality of life in survivors of childhood acute myeloid leukemia comparing post remission chemotherapy to BMT : A report from the children's oncology group. / Schultz, Kris Ann P; Chen, Lu; Chen, Zhengjia; Kawashima, Toana; Oeffinger, Kevin C.; Woods, William G.; Nicholson, H. Stacy; Neglia, Joseph P.

In: Pediatric Blood and Cancer, Vol. 61, No. 4, 01.04.2014, p. 729-736.

Research output: Contribution to journalArticle

Schultz, Kris Ann P ; Chen, Lu ; Chen, Zhengjia ; Kawashima, Toana ; Oeffinger, Kevin C. ; Woods, William G. ; Nicholson, H. Stacy ; Neglia, Joseph P. / Health conditions and quality of life in survivors of childhood acute myeloid leukemia comparing post remission chemotherapy to BMT : A report from the children's oncology group. In: Pediatric Blood and Cancer. 2014 ; Vol. 61, No. 4. pp. 729-736.
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abstract = "Background: Therapy for childhood acute myeloid leukemia (AML) has historically included chemotherapy with or without autologous bone marrow transplant (autoBMT) or allogeneic hematopoietic stem cell transplantation (alloBMT). We sought to compare health-related quality-of-life (HRQOL) outcomes between these treatment groups. Procedure: Five-year survivors of AML diagnosed before age 21 and enrolled and treated from 1979 to 1995 on one of 4 national protocols were interviewed. These survivors or proxy caregivers completed a health questionnaire and an HRQOL measure. Results: Of 180 survivors, 100 were treated with chemotherapy only, 26 with chemotherapy followed by autoBMT, and 54 with chemotherapy followed by alloBMT. Median age at interview was 20 years (range 8-39). Twenty-one percent reported a severe or life-threatening chronic health condition (chemotherapy-only 16{\%} vs. autoBMT 21{\%} vs. alloBMT 33{\%}; P=0.02 for chemotherapy-only vs. alloBMT). Nearly all (95{\%}) reported excellent, very good or good health. Reports of cancer-related pain and anxiety did not vary between groups. HRQOL scores among 136 participants ≥14 years of age were similar among groups and to the normative population, though alloBMT survivors had a lower physical mean summary score (49.1 alloBMT vs. 52.2 chemotherapy-only; P=0.03). Multivariate analyses showed the presence of severe chronic health conditions to be a strong predictor of physical but not mental mean summary scores. Conclusions: Overall HRQOL scores were similar among treatment groups, although survivors reporting more health conditions or cancer-related pain had diminished HRQOL. Attention to chronic health conditions and management of cancer-related pain may improve QOL. Pediatr Blood Cancer 2014;61:729-736.",
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T1 - Health conditions and quality of life in survivors of childhood acute myeloid leukemia comparing post remission chemotherapy to BMT

T2 - A report from the children's oncology group

AU - Schultz, Kris Ann P

AU - Chen, Lu

AU - Chen, Zhengjia

AU - Kawashima, Toana

AU - Oeffinger, Kevin C.

AU - Woods, William G.

AU - Nicholson, H. Stacy

AU - Neglia, Joseph P

PY - 2014/4/1

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N2 - Background: Therapy for childhood acute myeloid leukemia (AML) has historically included chemotherapy with or without autologous bone marrow transplant (autoBMT) or allogeneic hematopoietic stem cell transplantation (alloBMT). We sought to compare health-related quality-of-life (HRQOL) outcomes between these treatment groups. Procedure: Five-year survivors of AML diagnosed before age 21 and enrolled and treated from 1979 to 1995 on one of 4 national protocols were interviewed. These survivors or proxy caregivers completed a health questionnaire and an HRQOL measure. Results: Of 180 survivors, 100 were treated with chemotherapy only, 26 with chemotherapy followed by autoBMT, and 54 with chemotherapy followed by alloBMT. Median age at interview was 20 years (range 8-39). Twenty-one percent reported a severe or life-threatening chronic health condition (chemotherapy-only 16% vs. autoBMT 21% vs. alloBMT 33%; P=0.02 for chemotherapy-only vs. alloBMT). Nearly all (95%) reported excellent, very good or good health. Reports of cancer-related pain and anxiety did not vary between groups. HRQOL scores among 136 participants ≥14 years of age were similar among groups and to the normative population, though alloBMT survivors had a lower physical mean summary score (49.1 alloBMT vs. 52.2 chemotherapy-only; P=0.03). Multivariate analyses showed the presence of severe chronic health conditions to be a strong predictor of physical but not mental mean summary scores. Conclusions: Overall HRQOL scores were similar among treatment groups, although survivors reporting more health conditions or cancer-related pain had diminished HRQOL. Attention to chronic health conditions and management of cancer-related pain may improve QOL. Pediatr Blood Cancer 2014;61:729-736.

AB - Background: Therapy for childhood acute myeloid leukemia (AML) has historically included chemotherapy with or without autologous bone marrow transplant (autoBMT) or allogeneic hematopoietic stem cell transplantation (alloBMT). We sought to compare health-related quality-of-life (HRQOL) outcomes between these treatment groups. Procedure: Five-year survivors of AML diagnosed before age 21 and enrolled and treated from 1979 to 1995 on one of 4 national protocols were interviewed. These survivors or proxy caregivers completed a health questionnaire and an HRQOL measure. Results: Of 180 survivors, 100 were treated with chemotherapy only, 26 with chemotherapy followed by autoBMT, and 54 with chemotherapy followed by alloBMT. Median age at interview was 20 years (range 8-39). Twenty-one percent reported a severe or life-threatening chronic health condition (chemotherapy-only 16% vs. autoBMT 21% vs. alloBMT 33%; P=0.02 for chemotherapy-only vs. alloBMT). Nearly all (95%) reported excellent, very good or good health. Reports of cancer-related pain and anxiety did not vary between groups. HRQOL scores among 136 participants ≥14 years of age were similar among groups and to the normative population, though alloBMT survivors had a lower physical mean summary score (49.1 alloBMT vs. 52.2 chemotherapy-only; P=0.03). Multivariate analyses showed the presence of severe chronic health conditions to be a strong predictor of physical but not mental mean summary scores. Conclusions: Overall HRQOL scores were similar among treatment groups, although survivors reporting more health conditions or cancer-related pain had diminished HRQOL. Attention to chronic health conditions and management of cancer-related pain may improve QOL. Pediatr Blood Cancer 2014;61:729-736.

KW - Acute myeloid leukemia

KW - Bone marrow transplantation

KW - Chronic health condition

KW - Late effects

KW - Pediatric

KW - Quality of life

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