Health-related quality of life (HRQoL) is substantially lower throughout treatment among pediatric patients with acute lymphoblastic leukemia (ALL) compared with healthy children, though it improves through the duration of treatment, according to a study published in Pediatric Blood & Cancer.1
Long-term cure of ALL is achieved by 80% of children with the disease, but questions remain regarding how to balance morbidity and HRQoL related to treatment. This study assessed HRQoL of children from time of diagnosis to end of treatment for ALL during the UKALL 2003 trial (ClinicalTrials.gov Identifier: NCT00222612).
The randomized trial evaluated the efficacy and toxicity of ALL treatment allocated based on minimal residual disease. This analysis included 874 patients whose parents completed HRQoL and care-giving burden questionnaires at 5 time points.
Physical QoL was significantly lower for patients receiving ALL treatment at all time points (range, 26.78-74.47) compared with healthy children (89.32) and children (81.81) who are acutely ill (at all time points, P < .0005).
Psychosocial QoL was significantly lower beginning at time point 2 (range, 47.56-67.88) compared with healthy (86.58) and acutely ill children (79.56; P < .00005 all time points).
Treatment intensity did not affect overall HRQoL or care-giving burden, but less intense regimens were associated with better pain and nausea scores.
Older children had more concern about side effects and appearance, whereas younger children had greater procedural anxiety.
Care giving–burden also decreased throughout ALL treatment.
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According to the authors, “excellent survival rates mean that it is possible to reduce treatment intensity for some patients in an attempt to improve QoL.”
Though these findings should be confirmed with patient-reported measures, they may help the development of supportive interventions, wrote the authors.
- Eiser C, Stride CB, Vora A, et al. Prospective evaluation of quality of life in children treated in UKALL 2003 for acute lymphoblastic leukaemia: a cohort study. Pediatr Blood Cancer. 2017;e26615. doi: 10.1002/pbc.26615