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急性早幼粒细胞白血病长期生存者的健康相关生活质量、症状负担和合并症。

Health-related quality of life, symptom burden, and comorbidity in long-term survivors of acute promyelocytic leukemia.

机构信息

Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy.

Department of Cellular Biotechnologies and Hematology, "Sapienza" University of Rome, Rome, Italy.

出版信息

Leukemia. 2019 Jul;33(7):1598-1607. doi: 10.1038/s41375-018-0325-4. Epub 2018 Dec 20.

Abstract

The objective of this study was to investigate health-related quality of life (HRQOL), symptom burden, and comorbidity profile in long-term acute promyelocytic leukemia (APL) survivors treated with standard chemotherapy. Overall, 307 long-term APL survivors were invited to participate. HRQOL was assessed with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and compared with that of age and sex-matched controls from the general population. Symptom burden was assessed with the MD Anderson Symptom Inventory (MDASI) questionnaire and comorbidity profile was also investigated. Median follow-up time since diagnosis was 14.3 years (interquartile range: 11.1-16.9 years). APL survivors had a statistically and clinically meaningful worse score for the role physical scale of the SF-36 (-9.5; 95% CI, -15.7 to -3.2, P = 0.003) than their peers in the general population. Fatigue was reported as moderate to severe by 29% of patients and 84.4% reported at least one comorbidity. Prevalence of comorbidity in APL survivors was higher than that reported by the general population. Also, marked variations were found in the HRQOL profile by number of comorbidities. Even many years after treatment ends, APL survivors treated with standard chemotherapy do not fully recover as they report HRQOL limitations and a substantial burden of symptoms.

摘要

本研究旨在调查接受标准化疗的长期急性早幼粒细胞白血病 (APL) 幸存者的健康相关生活质量 (HRQOL)、症状负担和合并症特征。共有 307 名长期 APL 幸存者受邀参与本研究。采用医疗结局研究 36 项简明健康调查问卷 (SF-36) 评估 HRQOL,并与来自普通人群的年龄和性别匹配的对照进行比较。采用 MD 安德森症状量表 (MDASI) 问卷评估症状负担,并调查合并症特征。诊断后中位随访时间为 14.3 年 (四分位距:11.1-16.9 年)。APL 幸存者在 SF-36 的生理职能评分方面比普通人群的同龄人有统计学意义上和临床上更差的评分 (-9.5;95%CI,-15.7 至-3.2,P=0.003)。29%的患者报告疲劳为中度至重度,84.4%的患者报告至少有一种合并症。APL 幸存者的合并症患病率高于普通人群报告的患病率。此外,HRQOL 特征也因合并症的数量而存在显著差异。即使在治疗结束多年后,接受标准化疗的 APL 幸存者仍未完全康复,他们报告 HRQOL 受限和症状负担较大。

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