Nayiager T, Anderson L, Cranston A, Athale U, Barr R D
Service of Hematology-Oncology, McMaster Children's Hospital, Hamilton, ON, Canada.
Division of Hematology-Oncology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
Qual Life Res. 2017 May;26(5):1371-1377. doi: 10.1007/s11136-016-1462-8. Epub 2016 Nov 24.
Children with acute lymphoblastic leukemia (ALL), the commonest form of cancer in this age group, suffer considerable morbidity during treatment, with the majority returning to good health soon after therapy has been completed, as reflected in health-related quality of life (HRQL). However, survivors are at risk of many adverse health outcomes later, including obesity, measured by body mass index (BMI), that is compounded by limited physical activity. This study examined the HRQL of long-term survivors of ALL and its relationship to BMI and physical activity.
A cohort of 75 subjects who were more than 10 years from diagnosis was assessed for BMI (weight in kg/height in m) and completed two questionnaires. HRQL was measured by the multi-attribute, preference-based Health Utilities Index (HUI) instrument HUI23S4.15Q designed for self-report, and physical activity was quantified by the Habitual Activity Estimation Scale.
The mean utility scores for overall HRQL (HUI2 = 0.88, HUI3 = 0.83) were similar to those in the Canadian and US general population segments of equivalent age (HUI2 = 0.86, HUI3 = 0.85). However, the minimum scores (HUI2 = 0.23, HUI3 = -0.09) revealed a group of survivors with notable disabilities in the attributes of hearing, emotion, cognition, and pain. There were no statistically significant correlations between HRQL and BMI or between HRQL and physical activity, except for deafness and inactivity on weekdays.
Overall, long-term survivors of ALL in childhood enjoy good HRQL but some experience appreciable disability, though this is not associated with BMI or, in the main, with physical activity.
急性淋巴细胞白血病(ALL)是该年龄组最常见的癌症形式,患儿在治疗期间会出现相当高的发病率,不过大多数患儿在治疗结束后不久就能恢复健康,这一点体现在与健康相关的生活质量(HRQL)上。然而,ALL幸存者日后有面临许多不良健康后果的风险,包括肥胖(通过体重指数(BMI)衡量),而身体活动受限又使这一情况更加复杂。本研究调查了ALL长期幸存者的HRQL及其与BMI和身体活动的关系。
对75名确诊10年以上的受试者进行队列研究,评估其BMI(体重(千克)/身高(米)),并让他们完成两份问卷。HRQL通过多属性、基于偏好的健康效用指数(HUI)工具HUI23S4.15Q进行测量,该工具专为自我报告设计,身体活动通过习惯活动估计量表进行量化。
总体HRQL的平均效用得分(HUI2 = 0.88,HUI3 = 0.83)与加拿大和美国同年龄普通人群的得分相似(HUI2 = 0.86,HUI3 = 0.85)。然而,最低得分(HUI2 = 0.23,HUI3 = -0.09)显示,有一组幸存者在听力、情绪、认知和疼痛方面存在明显残疾。HRQL与BMI之间或HRQL与身体活动之间均无统计学上的显著相关性,除了耳聋和工作日不活动的情况。
总体而言,儿童ALL长期幸存者的HRQL良好,但有些人存在明显残疾,不过这与BMI无关,主要也与身体活动无关。