Department of Pediatrics, College of Medicine, Kaohsiung Medical University and Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Support Care Cancer. 2010 Dec;18(12):1581-7. doi: 10.1007/s00520-009-0781-5. Epub 2009 Dec 1.
Long-term survival of childhood leukemia has become a reality with treatment advancement; hence, the need to assess the survivors' health-related quality of life (HRQL) is essential. Although a growing number of Western studies have documented the considerable impact of diagnosis and treatment on HRQL in pediatric leukemia survivors, little finding has been reported in non-Western developing countries.
We used a previously validated 14-dimensional questionnaire, Child Health Questionnaire 50-item Parent Form (CHQ-PF 50), to examine the perceived HRQL of 32 child/adolescent survivors, currently aged 13.17 ± 2.49 years, who had experienced first complete continuous remission from leukemia for at least 3 years. The HRQL status was compared with that obtained from community subjects (N = 154) and survivors' nonadult siblings (N = 30). Intelligence quotients (IQ) and computerized neuropsychological assessments were performed for subjects.
The HRQL of leukemia survivors was noted to be worse than that of community children and nonadult siblings as reflected by significantly lower scores in both the physical summary and the psychosocial summary score of CHQ-PF 50. 15.6% of the survivors had impaired intelligence (estimated IQ below 70). 27.8% of the adolescents were impaired in the cognitive domains as assessed by neuropsychological tests.
In this Taiwanese single institution experience, pediatric leukemia survivors carried a morbidity burden into their teen years as reflected by worse HRQL than controls. These findings may guide the support required by this population.
随着治疗的进步,儿童白血病的长期生存已成为现实;因此,评估幸存者的健康相关生活质量(HRQL)是必要的。尽管越来越多的西方研究记录了诊断和治疗对儿科白血病幸存者 HRQL 的重大影响,但在非西方发展中国家,几乎没有发现相关研究。
我们使用了先前验证过的 14 维问卷,儿童健康问卷 50 项家长式(CHQ-PF 50),来评估 32 名年龄在 13.17±2.49 岁的儿童/青少年白血病幸存者的感知 HRQL,这些患者至少经历了 3 年的首次完全持续缓解。将 HRQL 状况与社区对照组(N=154)和幸存者的非成年兄弟姐妹(N=30)进行比较。对受试者进行智商(IQ)和计算机神经心理学评估。
白血病幸存者的 HRQL 明显差于社区儿童和非成年兄弟姐妹,这反映在 CHQ-PF 50 的身体总评分和心理社会总评分都明显较低。15.6%的幸存者存在智力受损(估计 IQ 低于 70)。27.8%的青少年在认知领域存在神经心理学测试评估的障碍。
在这项台湾单机构的经验中,儿科白血病幸存者在青少年时期仍存在发病负担,HRQL 比对照组差。这些发现可能为该人群提供支持的方向。