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J Adolesc Young Adult Oncol. 2017 Sep;6(3):470-476. doi: 10.1089/jayao.2017.0018. Epub 2017 Aug 24.

Adverse Health Outcomes and Associations with Self-Reported General Health in Childhood Lymphoma Survivors.

Author information

1
1 Department for Pediatric Cancers and Blood Disorders, Oslo University Hospital , Oslo, Norway .
2
2 National Advisory Unit on Late Effects After Cancer Treatment, Oslo University Hospital , Oslo, Norway .
3
3 Department of Oncology, Akershus University Hospital , Nordbyhagen, Norway .
4
4 Department of Oncology, Oslo University Hospital , Oslo, Norway .
5
5 Faculty of Medicine, University of Oslo , Oslo, Norway .
6
6 Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital , Oslo, Norway .
7
7 Department of Ophthalmology, Oslo University Hospital , Oslo, Norway .
8
8 Department of Respiratory Medicine, Oslo University Hospital , Oslo, Norway .
9
9 Department of Orthopedics, Oslo University Hospital , Oslo, Norway .

Abstract

BACKGROUND:

The increased incidence of physical and psychosocial adverse health outcomes (AHOs) in childhood lymphoma survivors (CLSs) is well known, but these AHOs' association with self-reported general health is rarely described.

AIM:

We explored this association among long-term CLSs.

METHODS:

In 124 CLSs (Hodgkin: 81; non-Hodgkin: 43; median age: 33 years), physical AHOs were graded based on slightly modified common toxicity criteria for adverse effects (CTCAE)-4 recommendations (Grade 0-3). Psychosocial AHOs (pain, work inability, fatigue, and mental distress) were mainly assessed by validated patient-reported questionnaires (Grade 0-2). The results were related to contemporary self-reported general health. Statistical significance: p < 0.01.

RESULTS:

At least one physical AHO was found in 120 CLSs, being of Grades 1, 2, and 3, respectively, in 43, 43, and 34 survivors. The prevalence of psychosocial AHOs (Grades 1 or 2) was 63%, being Grade 2 in 62 CLSs. The CLSs described their general health as significantly reduced compared with controls, with the greatest reduction for survivors in whom physical AHOs were combined with moderate to severe psychosocial AHOs.

CONCLUSION:

Psychosocial more than physical AHOs impact on CLSs' current self-reported general health. Clinicians responsible for follow-up of CLSs should be aware of the strong reduction of contemporary general health by Grade 2 psychosocial AHOs. The study challenges the use of the physician-assessed CTCAE-4 categories in long-term cancer survivors and emphasizes the need to develop instruments, which reflect both physical and psychosocial AHOs in these individuals.

KEYWORDS:

childhood malignant lymphoma; common toxicity criteria; long-term adverse outcomes

PMID:
28837384
DOI:
10.1089/jayao.2017.0018
[Indexed for MEDLINE]

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