Skip to main content
Erschienen in: Supportive Care in Cancer 12/2010

01.12.2010 | Original Article

Health-related quality of life and cognitive outcomes among child and adolescent survivors of leukemia

verfasst von: Shyh-Shin Chiou, Ren-Chin Jang, Yu-Mei Liao, Pinchen Yang

Erschienen in: Supportive Care in Cancer | Ausgabe 12/2010

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Long-term survival of childhood leukemia has become a reality with treatment advancement; hence, the need to assess the survivors’ health-related quality of life (HRQL) is essential. Although a growing number of Western studies have documented the considerable impact of diagnosis and treatment on HRQL in pediatric leukemia survivors, little finding has been reported in non-Western developing countries.

Methods

We used a previously validated 14-dimensional questionnaire, Child Health Questionnaire 50-item Parent Form (CHQ-PF 50), to examine the perceived HRQL of 32 child/adolescent survivors, currently aged 13.17 ± 2.49 years, who had experienced first complete continuous remission from leukemia for at least 3 years. The HRQL status was compared with that obtained from community subjects (N = 154) and survivors’ nonadult siblings (N = 30). Intelligence quotients (IQ) and computerized neuropsychological assessments were performed for subjects.

Results

The HRQL of leukemia survivors was noted to be worse than that of community children and nonadult siblings as reflected by significantly lower scores in both the physical summary and the psychosocial summary score of CHQ-PF 50. 15.6% of the survivors had impaired intelligence (estimated IQ below 70). 27.8% of the adolescents were impaired in the cognitive domains as assessed by neuropsychological tests.

Conclusions

In this Taiwanese single institution experience, pediatric leukemia survivors carried a morbidity burden into their teen years as reflected by worse HRQL than controls. These findings may guide the support required by this population.
Literatur
1.
Zurück zum Zitat Brenner H, Kaatsch P, Burkhardt-Hammer T, Harms DO, Schrappe M, Michaelis J (2001) Long-term survival of children with leukemia achieved by the end of the second millennium. Cancer 92:1977–1983CrossRefPubMed Brenner H, Kaatsch P, Burkhardt-Hammer T, Harms DO, Schrappe M, Michaelis J (2001) Long-term survival of children with leukemia achieved by the end of the second millennium. Cancer 92:1977–1983CrossRefPubMed
2.
Zurück zum Zitat Silverman LB, Gelber RD, Dalton VK, Asselin BL, Barr RD, Clavell LA, Hurwitz CA, Moghrabi A, Samson Y, Schorin MA, Arkin S, Declerck L, Cohen HJ, Sallan SE (2001) Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber Consortium Protocol 91–01. Blood 97:1211–1218CrossRefPubMed Silverman LB, Gelber RD, Dalton VK, Asselin BL, Barr RD, Clavell LA, Hurwitz CA, Moghrabi A, Samson Y, Schorin MA, Arkin S, Declerck L, Cohen HJ, Sallan SE (2001) Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber Consortium Protocol 91–01. Blood 97:1211–1218CrossRefPubMed
3.
Zurück zum Zitat Geenen MM, Cardous-Ubbink MC, Kremer LC, van den Bos C, van der Pal HJ, Heinen RC, Jaspers MW, Koning CC, Oldenburger F, Langeveld NE, Hart AA, Bakker PJ, Caron HN, van Leeuwen FE (2007) Medical assessment of adverse health outcomes in long-term survivors of childhood cancer. JAMA 297:2705–2715CrossRefPubMed Geenen MM, Cardous-Ubbink MC, Kremer LC, van den Bos C, van der Pal HJ, Heinen RC, Jaspers MW, Koning CC, Oldenburger F, Langeveld NE, Hart AA, Bakker PJ, Caron HN, van Leeuwen FE (2007) Medical assessment of adverse health outcomes in long-term survivors of childhood cancer. JAMA 297:2705–2715CrossRefPubMed
4.
Zurück zum Zitat Mody R, Li S, Dover DC, Sallan S, Leisenring W, Oeffinger KC, Yasui Y, Robison LL, Neglia JP (2008) Twenty-five year follow-up among survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. Blood 111:5515–5523CrossRefPubMed Mody R, Li S, Dover DC, Sallan S, Leisenring W, Oeffinger KC, Yasui Y, Robison LL, Neglia JP (2008) Twenty-five year follow-up among survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. Blood 111:5515–5523CrossRefPubMed
5.
Zurück zum Zitat Oeffinger KC, Eshelman DA, Tomlinson GE, Buchanan GR, Foster BM (2000) Grading of late effects in young adult survivors of childhood cancer followed in an ambulatory adult setting. Cancer 88:1687–1695CrossRefPubMed Oeffinger KC, Eshelman DA, Tomlinson GE, Buchanan GR, Foster BM (2000) Grading of late effects in young adult survivors of childhood cancer followed in an ambulatory adult setting. Cancer 88:1687–1695CrossRefPubMed
6.
Zurück zum Zitat Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kadan-Lottick NS, Schwartz CL, Leisenring W, Robison LL (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355:1572–1582CrossRefPubMed Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kadan-Lottick NS, Schwartz CL, Leisenring W, Robison LL (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355:1572–1582CrossRefPubMed
7.
Zurück zum Zitat Pui CH, Cheng C, Leung W, Rai SN, Rivera GK, Sandlund JT, Ribeiro RC, Relling MV, Kun LE, Evans WE, Hudson MM (2003) Extended follow-up of long-term survivors of childhood acute lymphoblastic leukemia. N Engl J Med 349:640–649CrossRefPubMed Pui CH, Cheng C, Leung W, Rai SN, Rivera GK, Sandlund JT, Ribeiro RC, Relling MV, Kun LE, Evans WE, Hudson MM (2003) Extended follow-up of long-term survivors of childhood acute lymphoblastic leukemia. N Engl J Med 349:640–649CrossRefPubMed
8.
Zurück zum Zitat Stevens MC, Mahler H, Parkes S (1998) The health status of adult survivors of cancer in childhood. Eur J Cancer 34:694–698CrossRefPubMed Stevens MC, Mahler H, Parkes S (1998) The health status of adult survivors of cancer in childhood. Eur J Cancer 34:694–698CrossRefPubMed
9.
Zurück zum Zitat Apajasalo M, Sintonen H, Siimes MA, Hovi L, Holmberg C, Boyd H, Makela A, Rautonen J (1996) Health-related quality of life of adults surviving malignancies in childhood. Eur J Cancer 32A:1354–1358CrossRefPubMed Apajasalo M, Sintonen H, Siimes MA, Hovi L, Holmberg C, Boyd H, Makela A, Rautonen J (1996) Health-related quality of life of adults surviving malignancies in childhood. Eur J Cancer 32A:1354–1358CrossRefPubMed
10.
Zurück zum Zitat Langeveld NE, Stam H, Grootenhuis MA, Last BF (2002) Quality of life in young adult survivors of childhood cancer. Support Care Cancer 10:579–600CrossRefPubMed Langeveld NE, Stam H, Grootenhuis MA, Last BF (2002) Quality of life in young adult survivors of childhood cancer. Support Care Cancer 10:579–600CrossRefPubMed
11.
Zurück zum Zitat Maunsell E, Pogany L, Barrera M, Shaw AK, Speechley KN (2006) Quality of life among long-term adolescent and adult survivors of childhood cancer. J Clin Oncol 24:2527–2535CrossRefPubMed Maunsell E, Pogany L, Barrera M, Shaw AK, Speechley KN (2006) Quality of life among long-term adolescent and adult survivors of childhood cancer. J Clin Oncol 24:2527–2535CrossRefPubMed
12.
Zurück zum Zitat Pemberger S, Jagsch R, Frey E, Felder-Puig R, Gadner H, Kryspin-Exner I, Topf R (2005) Quality of life in long-term childhood cancer survivors and the relation of late effects and subjective well-being. Support Care Cancer 13:49–56CrossRefPubMed Pemberger S, Jagsch R, Frey E, Felder-Puig R, Gadner H, Kryspin-Exner I, Topf R (2005) Quality of life in long-term childhood cancer survivors and the relation of late effects and subjective well-being. Support Care Cancer 13:49–56CrossRefPubMed
13.
Zurück zum Zitat Shankar S, Robison L, Jenney ME, Rockwood TH, Wu E, Feusner J, Friedman D, Kane RL, Bhatia S (2005) Health-related quality of life in young survivors of childhood cancer using the Minneapolis-Manchester Quality of Life-Youth Form. Pediatrics 115:435–442CrossRefPubMed Shankar S, Robison L, Jenney ME, Rockwood TH, Wu E, Feusner J, Friedman D, Kane RL, Bhatia S (2005) Health-related quality of life in young survivors of childhood cancer using the Minneapolis-Manchester Quality of Life-Youth Form. Pediatrics 115:435–442CrossRefPubMed
14.
Zurück zum Zitat Patrick DL, Chiang YP (2000) Measurement of health outcomes in treatment effectiveness evaluations: conceptual and methodological challenges. Med Care 38:II14–II25PubMed Patrick DL, Chiang YP (2000) Measurement of health outcomes in treatment effectiveness evaluations: conceptual and methodological challenges. Med Care 38:II14–II25PubMed
15.
Zurück zum Zitat Eiser C, Morse R (2001) A review of measures of quality of life for children with chronic illness. Arch Dis Child 84:205–211CrossRefPubMed Eiser C, Morse R (2001) A review of measures of quality of life for children with chronic illness. Arch Dis Child 84:205–211CrossRefPubMed
16.
Zurück zum Zitat Liu HC, Chen SH, Chang KH, Chiang LC, Liu CY, Chang HL, Tsai LL, Liang DC (2002) Overall and event-free survivals for acute lymphoblastic leukemia in children at a single institution in Taiwan. Pediatr Hematol Oncol 19:19–29CrossRefPubMed Liu HC, Chen SH, Chang KH, Chiang LC, Liu CY, Chang HL, Tsai LL, Liang DC (2002) Overall and event-free survivals for acute lymphoblastic leukemia in children at a single institution in Taiwan. Pediatr Hematol Oncol 19:19–29CrossRefPubMed
17.
Zurück zum Zitat Liang DC, Hung IJ, Yang CP, Lin KH, Chen JS, Hsiao TC, Chang TT, Pui CH, Lee CH, Lin KS (1999) Unexpected mortality from the use of E. coli L-asparaginase during remission induction therapy for childhood acute lymphoblastic leukemia: a report from the Taiwan Pediatric Oncology Group. Leukemia 13:155–160CrossRefPubMed Liang DC, Hung IJ, Yang CP, Lin KH, Chen JS, Hsiao TC, Chang TT, Pui CH, Lee CH, Lin KS (1999) Unexpected mortality from the use of E. coli L-asparaginase during remission induction therapy for childhood acute lymphoblastic leukemia: a report from the Taiwan Pediatric Oncology Group. Leukemia 13:155–160CrossRefPubMed
18.
Zurück zum Zitat Lin WY, Liu HC, Yeh TC, Wang LY, Liang DC (2008) Triple intrathecal therapy without cranial irradiation for central nervous system preventive therapy in childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 50:523–527CrossRefPubMed Lin WY, Liu HC, Yeh TC, Wang LY, Liang DC (2008) Triple intrathecal therapy without cranial irradiation for central nervous system preventive therapy in childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 50:523–527CrossRefPubMed
19.
Zurück zum Zitat Landgraf JM, Abetz L, Ware JE (1999) The CHQ User’s manual. HealthAct, Boston, MA Landgraf JM, Abetz L, Ware JE (1999) The CHQ User’s manual. HealthAct, Boston, MA
20.
Zurück zum Zitat Waters E, Salmon L, Wake M (2000) The parent-form Child Health Questionnaire in Australia: comparison of reliability, validity, structure, and norms. J Pediatr Psychol 25:381–391CrossRefPubMed Waters E, Salmon L, Wake M (2000) The parent-form Child Health Questionnaire in Australia: comparison of reliability, validity, structure, and norms. J Pediatr Psychol 25:381–391CrossRefPubMed
21.
Zurück zum Zitat Wechsler D (1991) Manual for the Wechsler intelligence scale for children, 3rd. Psychological Corp, New York Wechsler D (1991) Manual for the Wechsler intelligence scale for children, 3rd. Psychological Corp, New York
22.
Zurück zum Zitat Sattler J (1992) Assessment of children, revised and updated version. JM Sattler Publisher, Inc, San Diego Sattler J (1992) Assessment of children, revised and updated version. JM Sattler Publisher, Inc, San Diego
23.
Zurück zum Zitat Wechsler D (1997) Wechsler adult intelligence scale III. Psychological Corporation, San Antonio, Tex Wechsler D (1997) Wechsler adult intelligence scale III. Psychological Corporation, San Antonio, Tex
24.
Zurück zum Zitat Dwolatzky T, Whitehead V, Doniger GM, Simon ES, Schweiger A, Jaffe D, Chertkow H (2003) Validity of a novel computerized cognitive battery for mild cognitive impairment. BMC Geriatr 3:4CrossRefPubMed Dwolatzky T, Whitehead V, Doniger GM, Simon ES, Schweiger A, Jaffe D, Chertkow H (2003) Validity of a novel computerized cognitive battery for mild cognitive impairment. BMC Geriatr 3:4CrossRefPubMed
25.
Zurück zum Zitat Lydick E, Epstein RS (1993) Interpretation of quality of life changes. Qual Life Res 2:221–226CrossRefPubMed Lydick E, Epstein RS (1993) Interpretation of quality of life changes. Qual Life Res 2:221–226CrossRefPubMed
26.
Zurück zum Zitat Cohen J (1977) Statistical power analysis for behavioral science (Revised Edition). Academic, New York Cohen J (1977) Statistical power analysis for behavioral science (Revised Edition). Academic, New York
27.
Zurück zum Zitat Dolgin MJ, Somer E, Buchvald E, Zaizov R (1999) Quality of life in adult survivors of childhood cancer. Soc Work Health Care 28:31–43CrossRefPubMed Dolgin MJ, Somer E, Buchvald E, Zaizov R (1999) Quality of life in adult survivors of childhood cancer. Soc Work Health Care 28:31–43CrossRefPubMed
28.
Zurück zum Zitat Grant J, Cranston A, Horsman J, Furlong W, Barr N, Findlay S, Barr R (2006) Health status and health-related quality of life in adolescent survivors of cancer in childhood. J Adolesc Health 38:504–510CrossRefPubMed Grant J, Cranston A, Horsman J, Furlong W, Barr N, Findlay S, Barr R (2006) Health status and health-related quality of life in adolescent survivors of cancer in childhood. J Adolesc Health 38:504–510CrossRefPubMed
29.
Zurück zum Zitat Speechley KN, Barrera M, Shaw AK, Morrison HI, Maunsell E (2006) Health-related quality of life among child and adolescent survivors of childhood cancer. J Clin Oncol 24:2536–2543CrossRefPubMed Speechley KN, Barrera M, Shaw AK, Morrison HI, Maunsell E (2006) Health-related quality of life among child and adolescent survivors of childhood cancer. J Clin Oncol 24:2536–2543CrossRefPubMed
30.
Zurück zum Zitat Anderson V, Smibert E, Ekert H, Godber T (1994) Intellectual, educational, and behavioural sequelae after cranial irradiation and chemotherapy. Arch Dis Child 70:476–483CrossRefPubMed Anderson V, Smibert E, Ekert H, Godber T (1994) Intellectual, educational, and behavioural sequelae after cranial irradiation and chemotherapy. Arch Dis Child 70:476–483CrossRefPubMed
31.
Zurück zum Zitat Cousens P, Waters B, Said J, Stevens M (1988) Cognitive effects of cranial irradiation in leukaemia: a survey and meta-analysis. J Child Psychol Psychiatry 29:839–852CrossRefPubMed Cousens P, Waters B, Said J, Stevens M (1988) Cognitive effects of cranial irradiation in leukaemia: a survey and meta-analysis. J Child Psychol Psychiatry 29:839–852CrossRefPubMed
32.
Zurück zum Zitat Langer T, Martus P, Ottensmeier H, Hertzberg H, Beck JD, Meier W (2002) CNS late-effects after ALL therapy in childhood. Part III: neuropsychological performance in long-term survivors of childhood ALL: impairments of concentration, attention, and memory. Med Pediatr Oncol 38:320–328CrossRefPubMed Langer T, Martus P, Ottensmeier H, Hertzberg H, Beck JD, Meier W (2002) CNS late-effects after ALL therapy in childhood. Part III: neuropsychological performance in long-term survivors of childhood ALL: impairments of concentration, attention, and memory. Med Pediatr Oncol 38:320–328CrossRefPubMed
33.
Zurück zum Zitat Said JA, Waters BG, Cousens P, Stevens MM (1989) Neuropsychological sequelae of central nervous system prophylaxis in survivors of childhood acute lymphoblastic leukemia. J Consult Clin Psychol 57:251–256CrossRef Said JA, Waters BG, Cousens P, Stevens MM (1989) Neuropsychological sequelae of central nervous system prophylaxis in survivors of childhood acute lymphoblastic leukemia. J Consult Clin Psychol 57:251–256CrossRef
34.
Zurück zum Zitat Buizer AI, de Sonneville LM, van den Heuvel-Eibrink MM, Veerman AJ (2005) Chemotherapy and attentional dysfunction in survivors of childhood acute lymphoblastic leukemia: effect of treatment intensity. Pediatr Blood Cancer 45:281–290CrossRefPubMed Buizer AI, de Sonneville LM, van den Heuvel-Eibrink MM, Veerman AJ (2005) Chemotherapy and attentional dysfunction in survivors of childhood acute lymphoblastic leukemia: effect of treatment intensity. Pediatr Blood Cancer 45:281–290CrossRefPubMed
35.
Zurück zum Zitat von der Weid N, Mosimann I, Hirt A, Wacker P, Nenadov Beck M, Imbach P, Caflisch U, Niggli F, Feldges A, Wagner HP (2003) Intellectual outcome in children and adolescents with acute lymphoblastic leukaemia treated with chemotherapy alone: age- and sex-related differences. Eur J Cancer 39:359–365CrossRefPubMed von der Weid N, Mosimann I, Hirt A, Wacker P, Nenadov Beck M, Imbach P, Caflisch U, Niggli F, Feldges A, Wagner HP (2003) Intellectual outcome in children and adolescents with acute lymphoblastic leukaemia treated with chemotherapy alone: age- and sex-related differences. Eur J Cancer 39:359–365CrossRefPubMed
36.
Zurück zum Zitat Achenbach TM, McConaughy SH, Howell CT (1987) Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychol Bull 101:213–232CrossRefPubMed Achenbach TM, McConaughy SH, Howell CT (1987) Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychol Bull 101:213–232CrossRefPubMed
37.
Zurück zum Zitat Levi RB, Drotar D (1999) Health-related quality of life in childhood cancer: discrepancy in parent-child reports. Int J Cancer Suppl 12:58–64CrossRefPubMed Levi RB, Drotar D (1999) Health-related quality of life in childhood cancer: discrepancy in parent-child reports. Int J Cancer Suppl 12:58–64CrossRefPubMed
38.
39.
Zurück zum Zitat Theunissen NC, Vogels TG, Koopman HM, Verrips GH, Zwinderman KA, Verloove-Vanhorick SP, Wit JM (1998) The proxy problem: child report versus parent report in health-related quality of life research. Qual Life Res 7:387–397CrossRefPubMed Theunissen NC, Vogels TG, Koopman HM, Verrips GH, Zwinderman KA, Verloove-Vanhorick SP, Wit JM (1998) The proxy problem: child report versus parent report in health-related quality of life research. Qual Life Res 7:387–397CrossRefPubMed
40.
Zurück zum Zitat Sawyer M, Antoniou G, Toogood I, Rice M (1999) A comparison of parent and adolescent reports describing the health-related quality of life of adolescents treated for cancer. Int J Cancer Suppl 12:39–45CrossRefPubMed Sawyer M, Antoniou G, Toogood I, Rice M (1999) A comparison of parent and adolescent reports describing the health-related quality of life of adolescents treated for cancer. Int J Cancer Suppl 12:39–45CrossRefPubMed
Metadaten
Titel
Health-related quality of life and cognitive outcomes among child and adolescent survivors of leukemia
verfasst von
Shyh-Shin Chiou
Ren-Chin Jang
Yu-Mei Liao
Pinchen Yang
Publikationsdatum
01.12.2010
Verlag
Springer-Verlag
Erschienen in
Supportive Care in Cancer / Ausgabe 12/2010
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-009-0781-5

Weitere Artikel der Ausgabe 12/2010

Supportive Care in Cancer 12/2010 Zur Ausgabe

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

25.04.2024 NSCLC Nachrichten

Das Risiko für Rezidiv oder Tod von Patienten und Patientinnen mit reseziertem ALK-positivem NSCLC ist unter einer adjuvanten Therapie mit dem Tyrosinkinase-Inhibitor Alectinib signifikant geringer als unter platinbasierter Chemotherapie.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.