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Cancer Med. 2019 Aug;8(9):4454-4464. doi: 10.1002/cam4.2337. Epub 2019 Jun 12.

Quality of life in pediatric acute myeloid leukemia: Report from the Children's Oncology Group.

Author information

1
Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
2
The Children's Oncology Group, Monrovia, California.
3
Division of Biostatistics, University of Southern California, Los Angeles, California.
4
Division of Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario.
5
Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
6
Division of Oncology, AI Dupont, Wilmington, Delaware.
7
Division of Oncology, Seattle Children's Hospital, Seattle, Washington.
8
Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario.

Abstract

INTRODUCTION:

Objectives were used to describe guardian proxy-report and child self-report quality of life (QoL) during chemotherapy for pediatric acute myeloid leukemia (AML) patients.

METHODS:

Patients enrolled on the phase 3 AML trial AAML1031 who were 2-18 years of age with English-speaking guardians were eligible. Instruments used were the PedsQL Generic Core Scales, Acute Cancer Module, and Multidimensional Fatigue Scale. Assessments were obtained at the beginning of Induction 1 and following completion of cycles 2-4. Potential predictors of QoL included the total number of nonhematological grade 3-4 Common Terminology Criteria for Adverse Event (CTCAE) submissions.

RESULTS:

There were 505 eligible guardians who consented to participate and 348 of their children provided at least one self-report assessment. The number of submitted CTCAE toxicities was significantly associated with worse physical health summary scores (β ± standard error (SE) -3.00 ± 0.69; P < 0.001) and general fatigue (β ± SE -2.50 ± 0.66; P < 0.001). Older age was significantly associated with more fatigue (β ± SE -0.58 ± 0.25; P = 0.022). Gender, white race, Hispanic ethnicity, private insurance status, risk status, bortezomib assignment, and duration of neutropenia were not significantly associated with QoL.

DISCUSSION:

The number of CTCAE toxicities was the primary factor influencing QoL among children with AML. Reducing toxicities should improve QoL; identifying approaches to ameliorate them should be a priority.

KEYWORDS:

acute myeloid leukemia; fatigue; patient-reported outcome; pediatric; quality of life

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