Factors associated with poor quality of life in survivors of childhood acute lymphoblastic leukemia and lymphoma

Authors

  • Adriani Kanellopoulos MD,

    Corresponding author
    1. Department of Paediatric Medicine, Women and Children's Division, Oslo University Hospital, Rikshospitalet, Oslo, Norway
    2. Faculty of Medicine, University of Oslo, Norway
    • Department of Paediatric Medicine, Women and Children's Division, Oslo University Hospital, Rikshospitalet, P.O. Box 4950, Nydalen, N-0424 Oslo, Norway.
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  • Hanne Mari Hamre MD,

    1. Faculty of Medicine, University of Oslo, Norway
    2. National Resource Centre for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
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  • Alv A. Dahl MD, PhD,

    1. Faculty of Medicine, University of Oslo, Norway
    2. National Resource Centre for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
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  • Sophie D. Fosså MD, PhD,

    1. Faculty of Medicine, University of Oslo, Norway
    2. National Resource Centre for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
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  • Ellen Ruud MD, PhD

    1. Department of Paediatric Medicine, Women and Children's Division, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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  • Conflict of interest: Nothing to declare.

Abstract

Background

Previous studies of health-related quality of life (QoL) in childhood cancer survivors have hardly focused on factors associated with poor QoL. The aims of our study were: (1) to assess QoL in long-term survivors (LTSs) of childhood acute lymphoblastic leukemia (ALL) and lymphomas compared to age-matched controls from the general population (NORMs). (2) To investigate factors associated with poor QoL in LTSs.

Procedure

This population-based cross-sectional study enrolled 285 LTSs of ALL and lymphomas diagnosed between 1970 and 2002 at age <18 years. The LTSs completed an extensive mailed questionnaire including the Short Form 36 (SF-36) as QoL-measure. NORMs consisted of five age-matched controls for each LTS (N = 1,425). Poor QoL was defined as SF-36 physical or mental component summary score <40.

Results

The median age of LTSs' at survey was 30 years (range: 18–54), median follow-up time 21 years (range: 7–39). Compared to NORMs, LTSs scored significantly lower on 7 of 8 SF-36 subscales. Among LTSs 32% reported poor QoL versus 19% among NORMs (P < 0.001). Among LTSs, psychosocial, lifestyle- and health-related variables, but not type of malignancy, treatment factors or socio-demographic factors were clinically significantly associated with poor QoL in bivariate regression analyses. In multivariate analysis, levels of fatigue, anxiety and depression, as well as obesity and insomnia remained significantly associated with poor QoL.

Conclusion

Significantly more LTSs than age-matched NORMs experienced poor QoL. Clinically significant associations with fatigue, anxiety, depression, obesity and insomnia were observed, which may be amenable for interventions, and thereby improvement of QoL in LTSs. Pediatr Blood Cancer 2013; 60: 849–855. © 2013 Wiley Periodicals, Inc.

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