Quality of Life of Patients with Wiskott Aldrich Syndrome and X-Linked Thrombocytopenia: a Study of the Primary Immune Deficiency Consortium (PIDTC), Immune Deficiency Foundation, and the Wiskott-Aldrich Foundation

J Clin Immunol. 2019 Nov;39(8):786-794. doi: 10.1007/s10875-019-00689-2. Epub 2019 Oct 16.

Abstract

Background: We undertook a study to determine the impact of Wiskott Aldrich Syndrome (WAS) and X-linked thrombocytopenia (XLT) and their therapies upon the health-related quality of life (HRQOL) of patients and their families.

Materials and methods: We undertook a survey of patients and their families, who self-identified as having either WAS or XLT. We assessed the PedsQL™ 4.0, the parent proxy form, and the family impact module. These results were compared with normative data from previously published reports.

Results: Sixty-eight patients (29 patients completed both the PedsQL™ 4.0 and the parent proxy form; 21 completed only the PedsQL™ 4.0; and 18 completed only the parent proxy form) were included. In contrast to patient-reported outcomes, parents of patients who had a bone marrow transplant (BMT) reported that their children had better QOL scores compared with those who did not (82.6 vs. 73.3, p = 0.023). The QOL of patients vs. previously published normative data showed decreases in patient scores for psychosocial health (72.62 vs. 86.58, p = < 0.001), emotional functioning (69.91 vs. 82.64, p = < 0.001), social functioning (77.55 vs. 91.56, p = < 0.001), and school functioning (70.46 vs. 85.67, p = < 0.001). The family impact study revealed deficits in emotional, social, and cognitive functioning, communication, and worry.

Conclusion: These results show that patients with WAS/XLT are significantly impacted with respect to QOL. BMT offered a better QOL for patients according to parents, but not as reported by the patients. Future studies should incorporate QOL to provide more data and a better understanding of outcomes for long-term survivors and decision-making regarding BMT.

Keywords: Wiskott Aldrich Syndrome (WAS); X-linked thrombocytopenia (XLT); bone marrow transplant (BMT); quality of life (QOL).

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Bone Marrow Transplantation
  • Caregivers / psychology
  • Child
  • Child, Preschool
  • Decision Making
  • Genetic Diseases, X-Linked / complications
  • Genetic Diseases, X-Linked / immunology
  • Genetic Diseases, X-Linked / psychology*
  • Genetic Diseases, X-Linked / therapy
  • Humans
  • Male
  • Parents / psychology*
  • Patient Reported Outcome Measures*
  • Quality of Life*
  • Surveys and Questionnaires / statistics & numerical data
  • Survivors / psychology
  • Thrombocytopenia / complications
  • Thrombocytopenia / immunology
  • Thrombocytopenia / psychology*
  • Thrombocytopenia / therapy
  • Wiskott-Aldrich Syndrome / complications
  • Wiskott-Aldrich Syndrome / immunology
  • Wiskott-Aldrich Syndrome / psychology*
  • Wiskott-Aldrich Syndrome / therapy
  • Young Adult

Supplementary concepts

  • Thrombocytopenia 1