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J Pediatr Hematol Oncol. 2018 Nov;40(8):580-587. doi: 10.1097/MPH.0000000000001235.

Health Status and Health-related Quality of Life Measurement in Pediatric Cancer Clinical Trials: An Examination of the DFCI 00-01 Acute Lymphoblastic Leukemia Protocol.

Author information

1
Centre for Health Economics and Policy Analysis.
2
Departments of Health Research Methods, Evidence, and Impact.
3
Health Utilities Inc., Dundas.
4
Economics.
5
Nursing.
6
Dana-Farber Cancer Institute, and Boston Children's Hospital, Boston, MA.
7
Hôpital Sainte Justine, Montreal.
8
San Jorge Children's Hospital, San Juan, Puerto Rico.
9
Le Centre Hospitalier de l'Universite Laval, Quebec City, QC, Canada.
10
Columbia Presbyterian Medical Center, New York, NY.
11
Maine Children's Cancer Program, Scarborough, ME.
12
Hospital for Sick Children, Toronto, ON.
13
Pediatrics, McMaster University.
14
McMaster Children's Hospital, Hamilton.

Abstract

Health-related quality of life (HRQL) improved progressively during therapy and beyond in children treated for acute lymphoblastic leukemia on the Dana-Farber Cancer Institute (DFCI) 95-01 protocol. This study aimed to validate that trajectory in a successor study (DFCI 00-01) and to compare the HRQL of patients in the 2 studies. Children aged above 5 years were assessed during each phase of treatment (N=4) and 2 years after completion of therapy. Health status and HRQL were measured using Health Utilities Index (HUI) instruments, HUI2 and HUI3. Quality-adjusted life years (QALYs) were calculated and compared with the general population, and patients treated on DFCI 95-01. Over 5 intervals and 758 HUI assessments, mean HRQL increased progressively from remission induction to the time after treatment (P<0.001). During intensification, high-risk patients had lower HRQL than standard-risk patients (P<0.001). During remission induction, patients on DFCI 95-01 had lower HRQL than patients on DFCI 00-01. Patients on DFCI 00-01 had ~0.2 and 0.3 fewer QALYs than controls, measured by HUI2 and HUI3, respectively. QALYs for DFCI 00-01 patients during treatment were similar to those for DFCI 95-01 patients. The trajectory of improvement in HRQL during the treatment of acute lymphoblastic leukemia in children was confirmed.

PMID:
29901560
DOI:
10.1097/MPH.0000000000001235
[Indexed for MEDLINE]

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