Zheng Fangyuan, Dou Xuelin, Zhang Liqiang, Jin Jie, Zhang Yanli, Liu Bingcheng, Meng Li, Zhu Xiaofan, Lu Zesheng, Jia Yueping, Liu Huilan, Lin Hai, Zhou Li, Zhao Xielan, Yang Wei, Sun Hui, Qian Sixuan, Ma Hongxia, Wu Runhui, Zhang Leping, Jiang Qian
Department of Pediatrics, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China.
Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, No. 11 Xizhimen South Street, Beijing, 100044, China.
J Cancer Res Clin Oncol. 2022 Feb;148(2):341-350. doi: 10.1007/s00432-021-03832-y. Epub 2021 Oct 29.
This study aimed to explore the health-related quality of life (HRQoL) and associated variables in children with chronic myeloid leukemia in the chronic phase (CML-CP) receiving tyrosine kinase inhibitors (TKIs).
A cross-sectional questionnaire was given to children with CML and their parents, who were < 18 years at diagnosis of CML and < 19 years at study. The questionnaire comprised three parts, including demographic information, clinical information, and the Chinese version of Pediatric Quality of Life Inventory (PedsQL) Cancer Module 3.0 as HRQoL questionnaire.
A total of 240 respondents data were analyzed. Multivariate analysis showed that children with symptoms had worse pain (- 10.2; P < 0.001), nausea (- 17.3; P = 0.001), more treatment anxiety (- 7.2; P = 0.005), worse self-assessment appearance (- 7.1; P = 0.001), communication problems (- 6.4; P = 0.001), and worse HRQoL (- 7.0; P < 0.001). Children with mothers having low educational qualifications had worse pain (- 6.0; P = 0.014), more worried about future (- 5.4; P = 0.042), worse cognition problems (- 7.1; P = 0.002), worse communication problems (- 5.5; P = 0.008), and worse HRQoL (- 4.3; P = 0.005). Younger age children at study had more procedural anxiety (2.7; P = 0.001), treatment anxiety (- 1.7; P = 0.014) and cognition problem (3.6; P < 0.001), as well as worse HRQoL (1.8; P = 0.008). However, older age children at diagnosis were more worried about future (- 2.8; P = 0.001), worse self-assessment appearance (- 1.1; P = 0.042) and worse HRQoL (- 1.8; P = 0.007). Other variables significantly associated with worse HRQoL included female gender, rural household registration and their father's low education level. Parents reported more gastrointestinal disorders, were worried about the future and had less concern about appearance than their children.
Female gender, older age at diagnosis, younger age at study, lower mother's education level, and TKI-related symptoms are significantly associated with worse HRQoL in Children with CML. Children and their parents have different priorities in the HRQoL.
本研究旨在探讨接受酪氨酸激酶抑制剂(TKIs)治疗的慢性期慢性髓性白血病(CML-CP)患儿的健康相关生活质量(HRQoL)及相关变量。
对CML患儿及其父母进行横断面问卷调查,这些患儿诊断CML时年龄小于18岁,研究时年龄小于19岁。问卷包括三个部分,即人口统计学信息、临床信息以及作为HRQoL问卷的中文版儿童生活质量量表(PedsQL)癌症模块3.0。
共分析了240份受访者数据。多变量分析显示,有症状的患儿疼痛情况更差(-10.2;P<0.001)、恶心情况更差(-17.3;P=0.001)、治疗焦虑更多(-7.2;P=0.005)、自我评估外貌更差(-7.1;P=0.001)、沟通问题更严重(-6.4;P=0.001)以及HRQoL更差(-7.0;P<0.001)。母亲教育程度低的患儿疼痛情况更差(-6.0;P=0.014)、对未来更担忧(-5.4;P=0.042)、认知问题更严重(-7.1;P=0.002)、沟通问题更严重(-5.5;P=0.008)以及HRQoL更差(-4.3;P=0.005)。研究时年龄较小的患儿有更多的操作焦虑(2.7;P=0.001)、治疗焦虑(-1.7;P=0.014)和认知问题(3.6;P<0.001),以及更差的HRQoL(1.8;P=0.008)。然而,诊断时年龄较大的患儿对未来更担忧(-2.8;P=0.001)、自我评估外貌更差(-1.1;P=0.042)以及HRQoL更差(-1.8;P=0.007)。其他与更差HRQoL显著相关的变量包括女性性别、农村户籍以及父亲的低教育水平。父母报告的胃肠道疾病更多,对未来更担忧,且对外貌的关注比孩子少。
女性性别、诊断时年龄较大、研究时年龄较小、母亲教育水平较低以及TKI相关症状与CML患儿更差的HRQoL显著相关。患儿及其父母在HRQoL方面有不同的优先关注点。