Quality of life and chronic health conditions in childhood acute leukaemia survivors

Med Clin (Barc). 2019 Mar 1;152(5):167-173. doi: 10.1016/j.medcli.2018.05.014. Epub 2018 Jul 13.
[Article in English, Spanish]

Abstract

Background: Survival of childhood acute lymphoblastic leukaemia involves an increasing risk of long-term morbidities. Due to the impact of cancer treatment and comorbidities, AL survivors may experience a decrease in their health-related quality of life.

Objective: We aimed to describe the long-term comorbidities, related quality of life and their development predictors in these survivors.

Methods: cross-sectional study of 54 survivors aged ≥18 and who have a survival rate of more than 10 years. Quality of life was assessed by personal interview using SF-36 questionnaire.

Results: 53.7% of AL survivors developed more than one comorbidity (24.7% hypothyroidism; 20.3% obesity; 14.8% metabolic syndrome; 18.5% subclinical cardiac dysfunction); 20.3% of them were severe. 73.3% of high-risk leukaemias and 66.6% of patients treated with radiotherapy or stem cells transplantation reported long-term comorbidity, P<.05. Global quality of live score was: 86.3 (14) (classified as very good). Patients with high-risk acute leukaemia (83.2 vs. 89.5), severe long-term comorbidities (80.4 vs. 89.7) and females (81.8 vs. 89.9), reported worse quality of life, P<.05. Physical summary score was worse in: obese (80 vs. 92) and hypothyroid (84.9 vs. 92.4) and radiotherapy-treated survivors (82.3 vs. 87.5); mental summary was worse in survivors with hypogonadism (68.2 vs. 86.3) and trasplanted patients (77.2 vs. 83.1), P<.05.

Conclusions: Acute leukaemia survivors reported an increase prevalence of chronic comorbidities, related to cancer-treatment. Despite a decrease in scores for certain physical or mental items, global quality of life was very good in all acute leukaemia survivors, even better than compared with the general population.

Keywords: Acute childhood leukaemia; Calidad de vida; Childhood cancer survivors; Chronic health conditions; Comorbilidades crónicas; Leucemia aguda infantil; Quality of life; Supervivientes cáncer infantil; Tratamiento; Treatment.

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cancer Survivors*
  • Child
  • Child, Preschool
  • Chronic Disease
  • Comorbidity
  • Craniospinal Irradiation / adverse effects
  • Cross-Sectional Studies
  • Female
  • Heart Diseases / epidemiology
  • Humans
  • Hypogonadism / epidemiology
  • Hypothyroidism / epidemiology
  • Male
  • Metabolic Syndrome / epidemiology
  • Obesity / epidemiology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Prevalence
  • Quality of Life*
  • Risk Factors
  • Sex Factors
  • Stem Cell Transplantation / adverse effects
  • Survival Rate
  • Young Adult