Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Pediatr Blood Cancer. 2019 Mar;66(3):e27506. doi: 10.1002/pbc.27506. Epub 2018 Oct 25.
There are limited data describing fitness and associated health-related quality of life (HRQoL) in survivors of childhood Hodgkin lymphoma (HL).
Fitness was evaluated among 336 adult survivors of childhood-onset HL treated at St. Jude Children's Research Hospital and 327 controls who never had childhood cancer. The controls were frequency matched on age, sex, and race. Associations were examined between chronic disease and fitness and between fitness and HRQoL using a multivariable linear and logistic regression.
Male survivors had lower endurance (6-min walk [6MW] distance 604.4 ± 7.9 m vs 637.0 ± 7.5 m, P < 0.01), and worse neuropathy (modified Total Neuropathy Score [mTNS] 2.7 ± 0.2 vs 1.4 ± 0.2, P < 0.01) compared to controls. Female survivors had lower endurance (6MW distance 564.5 ± 6.9 m vs 590.6 ± 7.0 m, P < 0.01), quadriceps strength (145.7 ± 4.0 vs 163.4 ± 4.0 N·m per kilogram, P < 0.01), and worse neuropathy (mTNS 3.2 ± 0.2 vs 1.4 ± 0.3, P < 0.01) compared to controls. Moderate, severe/disabling, or life-threatening (grades 2-4) neurological conditions were associated with impaired quadriceps strength (odds ratio [OR] 2.94, 99% confidence interval [CI] 1.24-6.96) and impaired endurance (OR 2.96, 99% CI 1.28-6.69). Cardiovascular (OR 2.36, 99% CI 1.00-5.61) and pulmonary (OR 2.78, 99% CI 1.30-5.94) conditions were associated with impaired endurance. Quadriceps strength (β -6.44 ± 2.01, P < 0.01), endurance (β -4.63 ± 1.54, P < 0.01), and neuropathy (β -4.98 ± 1.14, P < 0.01) were associated with a lower physical component summary on the HRQoL.
Survivors of childhood HL, particularly those with neurological, cardiac, and pulmonary chronic conditions, are at risk for impaired fitness and HRQoL.
目前仅有有限的数据描述了儿童期霍奇金淋巴瘤（HL）幸存者的体能状况及其相关的健康相关生活质量（HRQoL）。
本研究评估了 336 名在圣裘德儿童研究医院接受治疗的儿童期发病 HL 成年幸存者和 327 名从未患有儿童癌症的对照组参与者的体能。对照组按照年龄、性别和种族进行频数匹配。使用多变量线性和逻辑回归来检验慢性疾病与体能之间以及体能与 HRQoL 之间的关联。
与对照组相比，男性幸存者的耐力（6 分钟步行距离 604.4±7.9m 与 637.0±7.5m，P<0.01）和神经病变（改良的总神经病变评分 [mTNS] 2.7±0.2 与 1.4±0.2，P<0.01）更差。女性幸存者的耐力（6 分钟步行距离 564.5±6.9m 与 590.6±7.0m，P<0.01）、股四头肌力量（145.7±4.0 与 163.4±4.0N·m/kg，P<0.01）和神经病变（mTNS 3.2±0.2 与 1.4±0.3，P<0.01）更差。中度、重度/失能或危及生命（2-4 级）神经疾病与股四头肌力量受损（比值比 [OR] 2.94，99%置信区间 [CI] 1.24-6.96）和耐力下降（OR 2.96，99%CI 1.28-6.69）相关。心血管疾病（OR 2.36，99%CI 1.00-5.61）和肺部疾病（OR 2.78，99%CI 1.30-5.94）与耐力下降相关。股四头肌力量（β-6.44±2.01，P<0.01）、耐力（β-4.63±1.54，P<0.01）和神经病变（β-4.98±1.14，P<0.01）与 HRQoL 的生理成分综合评分较低相关。
儿童期 HL 幸存者，特别是那些患有神经、心脏和肺部慢性疾病的幸存者，存在体能和 HRQoL 受损的风险。
