Prospective, Longitudinal Assessment of Quality of Life in Children from Diagnosis to Three Months off Treatment for Standard Risk (SR) Acute Lymphoblastic Leukemia (ALL): Results of Children's Oncology Group Study AALL0331

• Published in: International journal of cancer 2015-09, Vol.138 (2), p.332-339
• Main Authors: Mitchell, Hannah-Rose, Lu, Xiaomin, Myers, Regina M., Sung, Lillian, Balsamo, Lyn M., Carroll, William L., Raetz, Elizabeth, Loh, Mignon L., Mattano, Leonard A., Winick, Naomi J., Devidas, Meenakshi, Hunger, Stephen P., Maloney, Kelly, Kadan-Lottick, Nina S.
• Format: Article
• Language: English
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.29708

Standard risk acute lymphoblastic leukemia (SR-ALL) has high cure rates, but requires two to three years of therapy. We aimed to 1) prospectively evaluate health-related quality of life (HRQOL) during and after SR-ALL therapy, and 2) identify associated predictors. Parents of 160 SR-ALL patients enrolled on Children's Oncology Group (COG) therapeutic trial AALL0331 at 31 sites completed the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales (physical, emotional, and social functioning) and Family Assessment Device-General Functioning (FAD-GF) at one, six, and 12 months after diagnosis, and three months post-therapy. Mean PedsQL scores in physical, emotional, and social functioning were impaired one month after diagnosis but steadily improved. Three months post-therapy, impaired physical and social functioning was observed in 27.8% and 25.8% of patients, respectively. In repeated-measures analysis, problematic family functioning predicted emotional (OR=1.85, 95% CI 1.03-3.34) and social (OR=1.99, 95% CI 1.21-3.27) impairment. Larger household size was associated with social impairment (OR=1.21, 95% CI 1.02-1.45). Adverse neurological event(s) during therapy predicted post-therapy physical (OR=5.17, 95% CI 1.61-16.63) and social (OR=8.17, 95% CI 1.19-56.16) impairment. HRQOL one month after diagnosis was not predictive of HRQOL three months after therapy completion. In conclusion, children with SR-ALL experience considerable impairment in HRQOL at the end of induction, but rapidly improve. However, many still experience physical and social impairment three months post-therapy, suggesting a role for continued family and physical functioning support. Longer follow-up is needed to determine if post-therapy deficits change over time.