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慢性淋巴细胞白血病患者的生活质量:对1482例患者的国际调查

Quality of life in chronic lymphocytic leukemia: an international survey of 1482 patients.

作者信息

Shanafelt Tait D, Bowen Deborah, Venkat Chaya, Slager Susan L, Zent Clive S, Kay Neil E, Reinalda Megan, Sloan Jeff A, Call Timothy G

机构信息

Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

出版信息

Br J Haematol. 2007 Oct;139(2):255-64. doi: 10.1111/j.1365-2141.2007.06791.x.

Abstract

Although a diagnosis of chronic lymphocytic leukemia (CLL) can have a profound effect on the quality of life (QOL), few studies have objectively measured the QOL of CLL patients or compared it to the general population. We conducted an international, web-based survey of patients with CLL using standardized instruments with published population norms to evaluate fatigue and QOL. Co-morbid health conditions were assessed using the Charlson Co-Morbidity Index. Between June and October 2006, 1482 patients with CLL responded to the survey. The physical, social/family, functional, and overall QOL scores of CLL patients were similar to or better than published population norms. In contrast, the emotional well-being scores of CLL patients were dramatically lower than that of both the general population (P < 0.001) and patients with other types of cancer (P < 0.001). QOL scores were lower among individuals with advanced stage disease (all P < 0.05). Factors associated with lower overall QOL on multivariate analysis included older age, greater fatigue, severity of co-morbid health conditions, and current treatment. CLL has a profound impact on QOL at all disease stages. The effects of CLL on QOL appear to differ from that of other malignancies with a more marked impact on emotional QOL. Research identifying efficacious psycho-oncologic support interventions for patients with CLL is needed.

摘要

尽管慢性淋巴细胞白血病(CLL)的诊断会对生活质量(QOL)产生深远影响,但很少有研究客观地测量CLL患者的生活质量或将其与普通人群进行比较。我们使用具有已发表的人群常模的标准化工具,对CLL患者进行了一项基于网络的国际调查,以评估疲劳和生活质量。使用Charlson合并症指数评估合并的健康状况。在2006年6月至10月期间,1482例CLL患者对调查做出了回应。CLL患者的身体、社会/家庭、功能和总体生活质量得分与已发表的人群常模相似或更好。相比之下,CLL患者的情绪幸福感得分显著低于普通人群(P<0.001)和其他类型癌症患者(P<0.001)。晚期疾病患者的生活质量得分较低(所有P<0.05)。多变量分析中与总体生活质量较低相关的因素包括年龄较大、疲劳程度较高、合并健康状况的严重程度以及当前治疗。CLL在所有疾病阶段都对生活质量有深远影响。CLL对生活质量的影响似乎与其他恶性肿瘤不同,对情绪生活质量的影响更为明显。需要开展研究,为CLL患者确定有效的心理肿瘤支持干预措施。

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