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Psychosocial Study

Health status and quality of life in long-term survivors of childhood leukaemia: the impact of haematopoietic stem cell transplantation

Bone Marrow Transplantation volume 40, pages 897–904 (2007)Cite this article

Abstract

We compared late side effects and quality of life (QoL) in 430 survivors of childhood acute leukaemia based on whether they had undergone haematopoietic cell transplantation (n=142) or not (n=288). Mean age was 18.2 years and mean follow-up duration was 11.9 years. Multivariate logistic regression analyses were performed to compare the risk of each type of late effect in the two groups. Based on age, VSP-A or SF36 questionnaires were used to assess QoL. For each QoL dimension, multiple linear regression was done to construct models of association with the treatment group. Transplanted patients experienced more side effects, including height growth failure, gonadal dysfunction, hypothyroidism and cataract. Children and adolescents in the two treatment groups reported similar QoL levels for almost all dimensions except a better perception of school work by young transplanted children and more difficulties in relating to the medical staff for transplanted adolescents. In adults, two differences in physical domain of QoL were detected but the calculated effect sizes were less than 0.2 in each case, suggesting an uncertain clinical significance. In spite of a higher risk of physical adverse events in the transplanted group, very few clinically significant differences in QoL are detectable.

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References

  1. Hudson MM, Mertens AC, Yasui Y, Hobbie W, Chen H, Gurney JG et al. Health status of adult long-term survivors of childhood cancer: a report from the childhood cancer survivor study. JAMA 2003; 290: 1583–1592.

    Article  CAS  PubMed  Google Scholar 

  2. Mertens AC, Yasui Y, Neglia JP, Potter JD, Nesbit Jr ME, Ruccione K et al. Late mortality experience in five-year survivors of childhood and adolescent cancer: the childhood cancer survivor study. J Clin Oncol 2001; 19: 3163–3172.

    Article  CAS  PubMed  Google Scholar 

  3. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 2006; 355: 1572–1582.

    Article  CAS  PubMed  Google Scholar 

  4. Rivera GK, Pinkel D, Simone JV, Hancock ML, Crist WM . Treatment of acute lymphoblastic leukemia. 30 years’ experience at St. Jude Children's Research Hospital. N Engl J Med 1993; 329: 1289–1295.

    Article  CAS  PubMed  Google Scholar 

  5. Silverman LB, Sallan SE . Acute lymphoblastic leukaemia. In: Nathan DG, Orkin SH, Ginsburg D, Look AT (eds). Nathan and Oski's Hematology of Infancy and Chilhood, 6th edn. WB Saunders company: Philadelphia, 2003, pp 1135–1166.

    Google Scholar 

  6. Benett C, Hsu K, Look AT . Myeloid leukemia, myelodysplasia, and myeloproliferative disease in children. In: Nathan DG, Orkin SH, Ginsburg D, Look AT (eds). Nathan and Oski's hematology of Infancy and Chilhood, 6th edn. WB Saunders company: Philadelphia, 2003, pp 1167–1209.

    Google Scholar 

  7. Margolin JF, Steuber CP, Poplack DG . Acute lymphoblastic leukaemia. In: Pizzo PA, Poplack DG (eds). Principles and Pratice of Pediatric Oncology, 5th edn. Lippincott Williams and Wilkins: Philadelphia, 2006, pp 538–590.

    Google Scholar 

  8. Golub TR, Arceci RJ . Acute myelogeneous leukaemia. In: Pizzo PA, Poplack DG (eds). Principles and Pratice of Pediatric Oncology, 5th edn. Lippincott Williams and Wilkins: Philadelphia, 2006, pp 591–644.

    Google Scholar 

  9. Lange BJ, Bunin NJ . Therapy of acute myeloid leukaemia. In: Lilleyman J, Hann I, Blanchette V (eds). Pediatric Hematology. Churchill Livingstone: London, 2000, pp 387–403.

    Google Scholar 

  10. Liesner RJ, Leiper AD, Hann IM, Chessells JM . Late effects of intensive treatment for acute myeloid leukemia and myelodysplasia in childhood. J Clin Oncol 1994; 12: 916–924.

    Article  CAS  PubMed  Google Scholar 

  11. Michel G, Socie G, Gebhard F, Bernaudin F, Thuret I, Vannier JP et al. Late effects of allogeneic bone marrow transplantation for children with acute myeloblastic leukemia in first complete remission: the impact of conditioning regimen without total-body irradiation--a report from the societe francaise de greffe de moelle. J Clin Oncol 1997; 15: 2238–2246.

    Article  CAS  PubMed  Google Scholar 

  12. Sanders JE, Guthrie KA, Hoffmeister PA, Woolfrey AE, Carpenter PA, Appelbaum FR . Final adult height of patients who received hematopoietic cell transplantation in childhood. Blood 2005; 105: 1348–1354.

    Article  CAS  PubMed  Google Scholar 

  13. Pui CH, Relling MV . Long-term sequellae of chilhood acute lymphoblastic leukemia. Hematology 2002; 105: 168–173.

    Google Scholar 

  14. Leung W, Hudson MM, Strickland DK, Phipps S, Srivastava DK, Ribeiro RC et al. Late effects of treatment in survivors of childhood acute myeloid leukemia. J Clin Oncol 2000; 18: 3273–3279.

    Article  CAS  PubMed  Google Scholar 

  15. Pui CH, Cheng C, Leung W, Rai SN, Rivera GK, Sandlund JT et al. Extended follow-up of long-term survivors of childhood acute lymphoblastic leukemia. N Engl J Med 2003; 349: 640–649.

    Article  PubMed  Google Scholar 

  16. Zebrack BJ, Zeltzer LK, Whitton J, Mertens AC, Odom L, Berkow R et al. Psychological outcomes in long-term survivors of childhood leukemia, Hodgkin's disease, and non-Hodgkin's lymphoma: a report from the childhood cancer survivor study. Pediatrics 2002; 110: 42–52.

    Article  PubMed  Google Scholar 

  17. Ness KK, Mertens AC, Hudson MM, Wall MM, Leisenring WM, Oeffinger KC et al. Limitations on physical performance and daily activities among long-term survivors of childhood cancer. Ann Intern Med 2005; 143: 639–647.

    Article  PubMed  Google Scholar 

  18. Shankar S, Robison L, Jenney ME, Rockwood TH, Wu E, Feusner J et al. Health-related quality of life in young survivors of childhood cancer using the Minneapolis-Manchester quality of life-youth form. Pediatrics 2005; 115: 435–442.

    Article  PubMed  Google Scholar 

  19. Speechley KN, Barrera M, Shaw AK, Morrison HI, Maunsell E . Health-related quality of life among child and adolescent survivors of childhood cancer. J Clin Oncol 2006; 24: 2536–2543.

    Article  PubMed  Google Scholar 

  20. Maunsell E, Pogany L, Barrera M, Shaw AK, Speechley KN . Quality of life among long-term adolescent and adult survivors of childhood cancer. J Clin Oncol 2006; 24: 2527–2535.

    Article  PubMed  Google Scholar 

  21. Grant J, Cranston A, Horsman J, Furlong W, Barr N, Findlay S et al. Health status and health-related quality of life in adolescent survivors of cancer in childhood. J Adolesc Health 2006; 38: 504–510.

    Article  PubMed  Google Scholar 

  22. Langeveld NE, Stam H, Grootenhuis MA, Last BF . Quality of life in young adult survivors of childhood cancer. Support Care Cancer 2002; 10: 579–600.

    Article  CAS  PubMed  Google Scholar 

  23. Langeveld NE, Grootenhuis MA, Voute PA, de Haan RJ, van den Bos C . Quality of life, self-esteem and worries in young adult survivors of childhood cancer. Psychooncology 2004; 13: 867–881.

    Article  CAS  PubMed  Google Scholar 

  24. Dolgin MJ, Somer E, Buchvald E, Zaizov R . Quality of life in adult survivors of childhood cancer. Soc Work Health Care 1999; 28: 31–43.

    Article  CAS  PubMed  Google Scholar 

  25. Pemberger S, Jagsch R, Frey E, Felder-Puig R, Gadner H, Kryspin-Exner I et al. Quality of life in long-term childhood cancer survivors and the relation of late effects and subjective well-being. Support Care Cancer 2005; 13: 49–56.

    Article  PubMed  Google Scholar 

  26. Reulen RC, Winter DL, Lancashire ER, Zeegers MP, Jenney ME, Walters SJ et al. Health-status of adult survivors of childhood cancer: a large-scale population-based study from the british childhood cancer survivor study. Int J Cancer 2007; 121: 633–640.

    Article  CAS  PubMed  Google Scholar 

  27. Sempe P, Pedron G, Roy-Pernot MP . Auxologie, Méthode et Séquences. Theraplix: Paris, 1979.

    Google Scholar 

  28. Rolland-Cachera MF, Sempe M, Guilloud-Bataille M, Patois E, Pequignot-Guggenbuhl F, Fautrad V . Adiposity indices in children. Am J Clin Nutr 1982; 36: 178–184.

    Article  CAS  PubMed  Google Scholar 

  29. Simeoni MC, Sapin C, Antoniotti S, Auquier P . Health-related quality of life reported by French adolescents: a predictive approach of health status? J Adolesc Health 2001; 28: 288–294.

    Article  CAS  PubMed  Google Scholar 

  30. Sapin C, Simeoni MC, El Khammar M, Antoniotti S, Auquier P . Reliability and validity of the VSP-A, a health-related quality of life instrument for ill and healthy adolescents. J Adolesc Health 2005; 36: 327–336.

    Article  PubMed  Google Scholar 

  31. Auquier P, Clement A, Sapin C . Development, validation of HRQL measurement in children: VSP-Ae. Qual Life Res 2001; 10: 268.

    Google Scholar 

  32. Reulen RC, Zeegers MP, Jenkinson C, Lancashire ER, Winter DL, Jenney ME ; et al. The use of the SF-36 questionnaire in adult survivors of childhood cancer: evaluation of data quality, score reliability, and scaling assumptions. Health Qual Life Outcomes 2006; 4: 77.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Leplege A, Ecosse E, Verdier A, Perneger TV . The French SF-36 Health Survey: translation, cultural adaptation and preliminary psychometric evaluation. J Clin Epidemiol 1998; 51: 1013–1023.

    Article  CAS  PubMed  Google Scholar 

  34. Leplege A, Ecosse E, Pouchot J . Le Questionnaire MOS SF-36: Manuel de L’utilisateur et Guide d’Interprétation des Scores. Ed ESTEM: Paris, 2001.

    Google Scholar 

  35. Cohen J . Statistical Power Analysis for the Behavioural Sciences, 2nd edn. Lawrence Erlbaum Associates Publishers: Hillsdale, NJ, USA, 1988, 1000pp.

    Google Scholar 

  36. Norman GR, Sloan JA, Wyrwich KW . Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 2003; 41: 582–592.

    PubMed  Google Scholar 

  37. Cohen A, Rovelli A, Bakker B, Uderzo C, van Lint MT, Esperou H et al. Final height of patients who underwent bone marrow transplantation for hematological disorders during childhood: a study by the working party for late effects-EBMT. Blood 1999; 93: 4109–4115.

    CAS  PubMed  Google Scholar 

  38. Leung W, Rose SR, Zhou Y, Hancock ML, Burstein S, Schriock EA et al. Outcomes of growth hormone replacement therapy in survivors of childhood acute lymphoblastic leukemia. J Clin Oncol 2002; 20: 2959–2964.

    Article  CAS  PubMed  Google Scholar 

  39. Sanders J . Growth and development after hematopoietic cell transplantation. In: Blum KG, Forman SJ, Appelbaum FR (eds). Thomas’ Hematopoeitic Cell Transplantation, 3rd edn. Blackwell Publishing: Malden, MA, USA, 2004, pp 929–944.

    Google Scholar 

  40. Loning L, Zimmermann M, Reiter A, Kaatsch P, Henze G, Riehm H et al. Secondary neoplasms subsequent to Berlin–Frankfurt–Munster therapy of acute lymphoblastic leukemia in childhood: significantly lower risk without cranial radiotherapy. Blood 2000; 95: 2770–2775.

    CAS  PubMed  Google Scholar 

  41. Bhatia S, Sather HN, Pabustan OB, Trigg ME, Gaynon PS, Robison LL . Low incidence of second neoplasms among children diagnosed with acute lymphoblastic leukemia after 1983. Blood 2002; 99: 4257–4264.

    Article  CAS  PubMed  Google Scholar 

  42. Curtis RE, Rowlings PA, Deeg HJ, Shriner DA, Socie G, Travis LB et al. Solid cancers after bone marrow transplantation. N Engl J Med 1997; 336: 897–904.

    Article  CAS  PubMed  Google Scholar 

  43. Sorensen K, Levitt G, Bull C . Anthacycline dose in childhood acute lymphoblastic leukemia: issues of early survival versus late cardiotoxicity. J Clin Oncol 1999; 15: 61–68.

    Article  Google Scholar 

  44. Lipshultz SE, Lipsitz SR, Mone SM, Goorin AM, Sallan SE, Sanders SP et al. Female sex and drug dose as risk factors for late cardiotoxic effects of doxorubicin therapy for childhood cancer. N Engl J Med 1995; 332: 1738–1743.

    Article  CAS  PubMed  Google Scholar 

  45. Oeffinger KC, Mertens AC, Sklar CA, Yasui Y, Fears T, Stovall M et al. Obesity in adult survivors of childhood acute lymphoblastic leukemia: a report from the childhood cancer survivor study. J Clin Oncol 2003; 21: 1359–1365.

    Article  PubMed  Google Scholar 

  46. Apajasalo M, Sintonen H, Siimes MA, Hovi L, Holmberg C, Boyd H et al. Health-related quality of life of adults surviving malignancies in childhood. Eur J Cancer 1996; 32A: 1354–1358.

    Article  CAS  PubMed  Google Scholar 

  47. Albrecht GL, Devlieger PJ . The disability paradox: high quality of life against all odds. Soc Sci Med 1999; 48: 977–988.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Pediatric Haematology and Public Health Departments, Centre Hospitalo-Université de Marseille, Marseille, France

    G Michel, M-C Simeoni, C Curtillet, S Robitail, I Thuret, H Chambost, D Orbicini & P Auquier

  2. Pediatric Haematology Department, Centre Hospitalo-Université de Nancy, Nancy, France

    P Bordigoni, S Hoxha & S Pall-Kondolff

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  1. G Michel
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Correspondence to G Michel.

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Michel, G., Bordigoni, P., Simeoni, MC. et al. Health status and quality of life in long-term survivors of childhood leukaemia: the impact of haematopoietic stem cell transplantation. Bone Marrow Transplant 40, 897–904 (2007). https://doi.org/10.1038/sj.bmt.1705821

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